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Updated: Jun 23, 2026

Bilateral Common Carotid Artery Occlusion as an Adequate Preconditioning Stimulus to Induce Early Ischemic Tolerance to Focal Cerebral Ischemia
07:46

Bilateral Common Carotid Artery Occlusion as an Adequate Preconditioning Stimulus to Induce Early Ischemic Tolerance to Focal Cerebral Ischemia

Published on: May 9, 2013

Cerebral hyperperfusion syndrome post-carotid artery stenting

G S-S Tan1, C C Phatouros

  • 1Department of Interventional Neuroradiology, Royal Perth Hospital, Perth, Western Australia, Australia.

Journal of Medical Imaging and Radiation Oncology
|May 21, 2009
PubMed

Insights

Cerebral hyperperfusion syndrome is a rare but serious complication after carotid artery stenting. Early stenting for severe stenosis may increase the risk of stroke or cerebral hemorrhage.

Area of Science:

  • Neurology
  • Vascular Surgery

Background:

  • Cerebral hyperperfusion syndrome (CHS) is a recognized complication following carotid artery stenting (CAS) for severe internal carotid artery stenosis.
  • This study investigates the incidence and characteristics of CHS after CAS.

Observation:

  • A review of 170 CAS cases between 1999 and 2006 identified four patients who developed CHS.
  • These included cerebral edema, petechial hemorrhage, and large intracerebral hemorrhages, with one fatality.

Findings:

  • The overall risk of CHS was 2.3%.
  • Patients experiencing large intracerebral hemorrhage presented within 6 hours and had CAS within 3 weeks of symptom onset for critical stenosis (≥95%).
  • Early intervention in cases of critical stenosis appears to correlate with a higher risk of severe hemorrhage.

Implications:

  • CHS is an uncommon yet significant risk associated with CAS.
  • Further research comparing endarterectomy and CAS, particularly regarding early treatment timing, is warranted to optimize patient outcomes.

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