Effectiveness of staged angioplasty for avoidance of cerebral hyperperfusion syndrome after carotid revascularization

Mikito Hayakawa, Kenji Sugiu, Shinichi Yoshimura, Tomohito Hishikawa, Hiroshi Yamagami, Mayumi Fukuda-Doi, Nobuyuki Sakai, Koji Iihara, Kuniaki Ogasawara, Hidenori Oishi, Yasushi Ito, Yuji Matsumaru

研究成果: Contribution to journalArticle査読

5 被引用数 (Scopus)

抄録

OBJECTIVE Cerebral hyperperfusion syndrome (CHS) is a serious complication after carotid artery stenting (CAS). Staged angioplasty (SAP)-i.e., angioplasty followed by delayed CAS-has been reported as a potential CHS-Avoiding procedure. The purpose of this study was to clarify the effectiveness of SAP in avoiding CHS after carotid revascularization for patients at high risk for this complication. METHODS The authors retrospectively studied cases involving patients at high risk for CHS from 44 Japanese centers who were scheduled for SAP, regular CAS, angioplasty, or staged procedures other than SAP between October 2007 and March 2014. They investigated the rate of CHS in the population scheduled for SAP or regular CAS, and for safety analysis, the composite rate of transient ischemic attack (TIA) and ischemic stroke in the population eventually receiving SAP or regular CAS. RESULTS Data from a total of 525 patients (532 lesions, mean age 72.5 ± 7.5 years, 74 women ) were analyzed. Scheduled procedures included SAP for 113 lesions and regular CAS for 419 lesions. The rate of CHS was lower in the SAP group than in the regular CAS group (4.4% vs 10.5%, p = 0.047). Multivariate analysis showed that SAP was negatively related to CHS (OR 0.315; 95% CI 0.120 0.828). In the population eventually receiving SAP (102 lesions) or regular CAS (428 lesions), the composite rate of TIA and ischemic stroke was comparable between the SAP group and the regular CAS group (9.8% vs 9.3%). CONCLUSIONS SAP may be an effective and safe carotid revascularization procedure to avoid CHS.

本文言語英語
ページ(範囲)51-61
ページ数11
ジャーナルJournal of Neurosurgery
132
1
DOI
出版ステータス出版済み - 2020

All Science Journal Classification (ASJC) codes

  • 外科
  • 臨床神経学

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