Effect of perioperative blood pressure variability on cerebral hyperperfusion syndrome after carotid artery stenting:
Guo-Yong He1,2, Yan-Hua Li1,2, Jun-Jie Wei1,2
1Department of Neurology, the 477292People's Hospital of Guangxi Zhuang Autonomous region, China.
Insights
Perioperative blood pressure variability, including systolic and diastolic measures, is linked to an increased risk of cerebral hyperperfusion syndrome following carotid artery stenting. Monitoring blood pressure fluctuations is crucial for patient outcomes.
Area of Science:
- Cardiovascular Surgery
- Neurology
- Critical Care Medicine
Background:
- Cerebral hyperperfusion syndrome (CHS) is a potential complication after carotid artery stenting (CAS).
- Understanding risk factors for CHS is essential for improving patient safety and outcomes.
Purpose of the Study:
- To investigate the association between perioperative blood pressure variability and the incidence of CHS after CAS.
- To identify specific blood pressure parameters that may predict CHS risk.
Main Methods:
- Retrospective analysis of 418 patients undergoing CAS.
- Collection of blood pressure data during and after the procedure.
- Evaluation of blood pressure variability using metrics like standard deviation and max-min difference for systolic and diastolic blood pressure.
Main Results:
- 4.8% of patients developed CHS.
- Multivariate analysis revealed significant associations between various systolic blood pressure variability parameters (SBPMax, SBPMin, SBPMax-Min, SBPCV) and CHS.
- Diastolic blood pressure variability parameters (DBPSD, DBPMax, DBPMin, DBPMax-Min, DBPCV) were also significantly associated with CHS occurrence.
Conclusions:
- Perioperative blood pressure variability is a potential risk factor for developing cerebral hyperperfusion syndrome after carotid artery stenting.
- Specific measures of blood pressure fluctuation during the perioperative period are correlated with CHS incidence.
Objective:
To investigate the effect of perioperative blood pressure variability on cerebral hyperperfusion syndrome after carotid artery stenting.
Methods:
A retrospective analysis was conducted of data collected from 418 patients who underwent carotid artery stenting in Guangxi Zhuang Autonomous Region People's Hospital in China. The blood pressure data were collected during operation (after balloon dilation, before stent release, after stent release) and within 3 days after the operation. The blood pressure variability was evaluated by measuring the mean, maximum, minimum, max-min, standard deviation (SD) of systolic blood pressure (SBP) and diastolic blood pressure (DBP). The correlation between blood pressure variability and cerebral hyperperfusion syndrome was analysed.
Results:
Blood pressure data from 418 patients were analysed. Twenty patients (4.8%) developed cerebral hyperperfusion syndrome. The parameters of blood pressure variability were divided into four groups according to quartile. After adjusting for age, symptomatic carotid stenosis, unilateral carotid stenosis, bilateral carotid stenosis, collateral circulation, diabetes mellitus and chronic kidney disease, multivariate analysis showed that SBPMax, SBPMin, SBPMax-Min, SBPCV, DBPSD, DBPMax, DBPMin, DBPMax-Min and DBPCV were associated with the occurrence of cerebral hyperperfusion syndrome (P < 0.05), respectively.
Conclusion:
This study suggests that blood pressure variability during the perioperative period may increase the risk of cerebral hyperperfusion syndrome.
