国家神经系统疾病临床医学研究中心数据管理与共享系统

Data Management And Sharing System of China National Clinical Research Center for Neurological Diseases

《国家中心数据管理与共享系统操作说明书 —— 研究者部分》

Staged carotid artery angioplasty and stenting for patients with high-grade carotid stenosis with high risk of developing hyperperfusion injury: a retrospective analysis of 44 cases

第一作者：Dapeng Mo,Gang Luo

通讯作者：Zhongrong Miao

carotid artery angioplasty high-grade carotid sten

基本信息

2016-11-04

已发表文章

发表杂志：Stroke and Vascular Neurology

发表类型: Original Contributions

影响因子(IF): 4.081

PMID: 28959477 Pubmed原文链接 全文下载

主要研究背景及目的

Hyperperfusion syndrome (HPS) is a rare but potentially a life-threatening complication aftercarot id artery angioplasty and stenting (CAS). Staged CAS has been an alternative to prevent HPS.

方法

44 of 908 patients with high-grade internal carotid artery stenosis or near occlusion were at risk of HPS because of poor collateral flow and impaired cerebral blood flow (CBF). They were treated with first (stage 1), followed by a full CAS (stage 2) 1 month later. Their 30-day outcomes were tabulated and analysed.

结论

Staged carotid artery stenting probably decreased the chance of developing HPS in this group of selected patients. Although requiring a 2-step intervention, staged CAS may be a safe and effective alternative.

主要结果

During follow-up, 1 of the 44 (2.2%) patients developed HPS immediately, 3 (7%) had postprocedural HPS (ie, transcranial Doppler (TCD) >120%) without clinical symptoms and 3 (7%) required stenting at stage 1 for carotid dissections. After stage 1, there were significant improvement between the preprocedural and postprocedural CBF (0.98±0.06 vs 0.85±0.05, p<0.05), mean transit time (MTT; 1.05±0.05 vs 1.15±0.05, p<0.05), time to peak (TTP; 1.04±0.06 vs 1.20±0.06, p<0.05) on CT perfusion (CTP), and CBF (66.41±7.41 vs 44.44±6.43, p<0.05) on TCD. After stage 2, improvement was seen in CBF (1.01±0.07 vs 0.98±0.06, p<0.05), MTT (1.01 ±0.05 vs 1.05±0.05, p<0.05), TTP (0.99±0.06 vs 1.04 ±0.06, p<0.05) on CTP and CBF (66.41±7.41 vs 93.78 ±18.81, p<0.05) on TCD. 2 had postoperative increase of middle cerebral artery mean flow velocity of 120% after stage 2 without clinical symptoms.