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Haemorrhagic complication following percutaneous transluminal angioplasty for carotid stenosis
O Masuo1, T Terada, H Matsumoto
1Department of Neurological Surgery, Wakayama Medical College, Wakayama-City, Japan.
Insights
Two patients experienced bleeding after carotid angioplasty. Post-procedure hyperperfusion, indicated by increased blood flow velocity and transit time, is suggested as the cause of these hemorrhagic complications.
Area of Science:
- Neurology
- Vascular Surgery
- Radiology
Background:
- Percutaneous transluminal angioplasty (PTA) is a common procedure for treating carotid stenosis.
- Hemorrhagic complications following PTA, though rare, can be severe.
Observation:
- Two cases of hemorrhagic complications after carotid PTA are presented.
- Computed tomography (CT) revealed subarachnoid hemorrhage in one patient and intracerebral hemorrhage in another.
- Cerebral blood flow velocity and mean transit time were measured using transcranial Doppler (TCD) and dynamic CT in the patient with intracerebral hemorrhage.
Findings:
- The patient with intracerebral hemorrhage showed significantly increased cerebral blood flow velocity and peak height.
- These hemodynamic changes suggest a state of postoperative hyperperfusion.
Implications:
- Postoperative hyperperfusion may be a causative factor in hemorrhagic complications after carotid PTA.
- This finding highlights the importance of monitoring cerebral hemodynamics post-procedure.
- Further research is warranted to elucidate the mechanisms and preventative strategies for hyperperfusion-related complications.
Abstract:
We report 2 cases with haemorrhagic complications following percutaneous transluminal angioplasty (PTA) for carotid stenosis. Computed tomography (CT) scanning of these cases demonstrated diffuse subarachnoid haemorrhage in 1 case, and intracerebral haemorrhage in the other case on the next day after PTA. In the latter case, we measured cerebral blood flow velocity and mean transit time with transcranial doppler (TCD) and dynamic CT scan, which demonstrated remarkable increases in the blood flow velocity and peak height, respectively. From these results, postoperative hyperperfusion was suggested to have caused haemorrhagic complications.