Risk factors and preventive measures of cerebral hyperperfusion syndrome after carotid artery interventional therapy

Area of Science:

• Neurology
• Vascular Surgery
• Cardiology

Background:

• Cerebral hyperperfusion syndrome (CHS) is a potential complication following carotid artery interventional therapy.
• Identifying risk factors for CHS is crucial for improving patient outcomes and developing preventive strategies.

Purpose of the Study:

• To investigate the risk factors associated with cerebral hyperperfusion syndrome (CHS) after carotid artery stenting.
• To explore potential preventive measures for CHS in patients undergoing carotid artery intervention.

Main Methods:

• Retrospective analysis of clinical data from 382 patients who underwent carotid artery stenting.
• Comparison of patient characteristics between groups with and without CHS.
• Logistic regression analysis and ROC curve analysis to identify independent risk factors and predictive values.

Main Results:

• Patients in the CHS group had higher incidences of coronary heart disease, diabetes, progressive neurological disease, and transient recurrent cerebral hemorrhage.
• Significant differences were observed in internal carotid artery siphon stenosis, plaque extension (>3 cm), and carotid pressure gradients (>60 mmHg) between groups.
• Preoperative diabetes mellitus and a carotid pressure gradient ≥60 mmHg were identified as independent risk factors for CHS (p<0.05).
• The ROC curve analysis indicated a carotid pressure gradient ≥60 mmHg as a strong predictor for CHS, with an area under the curve of 0.949.

Conclusions:

• Preoperative diabetes mellitus and a carotid pressure gradient ≥60 mmHg are significant independent risk factors for developing CHS after carotid artery stenting.
• These identified indicators necessitate careful preoperative evaluation to mitigate the risk of CHS.