scholarly journals Assessment of the Cerebral Hemodynamic Benefits of Carotid Artery Stenting for Patients with Preoperative Hemodynamic Impairment Using Cerebral Single Photon Emission Computed Tomography (SPECT) and Carbon Dioxide Inhalation

2018 ◽  
Vol 24 ◽  
pp. 5398-5404 ◽  
Author(s):  
Da-Wei Chen ◽  
Jin Zheng ◽  
Jin Shi ◽  
Yang-wei Yin ◽  
Chen Song ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Carbon Dioxide ◽  
Carotid Artery ◽  
Single Photon ◽  
Photon Emission ◽  
Emission Computed Tomography ◽  
Single Photon Emission ◽  
Hemodynamic Impairment ◽  
Single Photon Emission Computed ◽  
Photon Emission Computed Tomography

Staged Angioplasty for Carotid Artery Stenosis to Prevent Postoperative Hyperperfusion

2009 ◽  
Vol 64 (suppl_1) ◽  
pp. ONS122-ONS129 ◽  
Author(s):  
Shinichi Yoshimura ◽  
Hideomi Kitajima ◽  
Yukiko Enomoto ◽  
Kiyofumi Yamada ◽  
Toru Iwama
Keyword(s):  
Computed Tomography ◽  
High Risk ◽  
Carotid Artery ◽  
Single Photon ◽  
Photon Emission ◽  
Emission Computed Tomography ◽  
Single Photon Emission ◽  
Carotid Revascularization ◽  
Single Photon Emission Computed ◽  
Photon Emission Computed Tomography

Abstract Objective: Hyperperfusion (HP) is a rare but potentially devastating complication after carotid revascularization. This report describes the clinical efficacy of staged angioplasty (SAP) for carotid artery stenosis to prevent HP after carotid revascularization. Methods: Eighteen of 143 patients with high-grade internal carotid artery stenosis scheduled for angioplasty were considered at high risk of postprocedure HP based on their severely impaired cerebral blood flow (CBF) and cerebral vasoreactivity, which were determined using single-photon emission computed tomography with acetazolamide. Nine of the high-risk patients were treated with carotid artery stenting and the other 9 were treated with SAP, which consisted of balloon angioplasty with undersized balloon catheters (Stage 1) followed by carotid artery stenting 1 to 2 months later (Stage 2). Results: In the regular carotid artery stenting group, 5 of 9 patients (56%) showed HP phenomenon on single-photon emission computed tomography just after stenting, and 1 patient (11%) developed status epilepticus owing to HP. In the SAP group, none of the 8 patients treated by SAP or the 1 patient who required stent placement during the first stage owing to a wall dissection developed postprocedure HP phenomenon or HP syndrome. Conclusion: SAP decreased the HP phenomenon on single-photon emission computed tomography after performing these procedures in selected patients. Although additional intervention is needed, SAP is considered a relatively simple and effective method to avoid HP in patients at high risk of HP after carotid revascularization.

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