Risk factors for cerebral hyperperfusion syndrome after carotid revascularization: a meta-analysis involving 158,624
Chun Wang1, Qiuhui Ran1, Rongrui Tang1
1Department of Neurosurgery, The University-Town Hospital of Chongqing Medical University, Chongqing, China.
Insights
Diabetes, coronary artery disease, stroke history, degree of stenosis, and early operation increase risk for cerebral hyperperfusion syndrome (CHS) after carotid revascularization. Robust collateral circulation is protective.
Area of Science:
- Neurology
- Vascular Surgery
- Medical Research
Background:
- Cerebral hyperperfusion syndrome (CHS) is a potential complication following carotid revascularization.
- Identifying risk factors is crucial for preventing CHS and improving patient outcomes.
Purpose of the Study:
- To identify and analyze the risk and protective factors associated with cerebral hyperperfusion syndrome (CHS) after carotid revascularization.
Main Methods:
- A comprehensive meta-analysis was conducted.
- Searched multiple databases including Cochrane Library, PubMed, Embase, Web of Science, CBM, CNKI, VIP, and Wanfang.
- Included ten studies with a total of 158,624 participants.
Main Results:
- Diabetes, coronary artery disease, history of stroke, degree of stenosis, and an operation time window of less than two weeks were identified as significant risk factors for CHS.
- Robust collateral circulation was found to be a significant protective factor against CHS.
- Factors such as male gender, hypertension, hyperlipidemia, alcohol consumption, smoking history, and intraoperative/post-operative hypertension did not show a significant association with CHS.
Conclusions:
- This study elucidates key risk and protective factors for CHS post-carotid revascularization.
- Findings can inform clinical practice for CHS prevention and management strategies.
Introduction:
This study aimed to identify the risk factors associated with cerebral hyperperfusion syndrome (CHS) following carotid revascularization.
Material And Methods:
Comprehensive searches of the Cochrane Library, PubMed, Embase, Web of Science, CBM, CNKI, VIP, and Wanfang databases yielded potentially eligible studies published up to April 30, 2024. We conducted a meta-analysis using RevMan 5.3.
Results:
Our analysis incorporated ten studies, encompassing 158,624 participants. The results demonstrated that diabetes (OR = 3.16, 95% CI (1.26, 7.93), p = 0.01), coronary artery disease (OR = 1.69, 95% CI (1.04, 2.74), p = 0.03), a history of stroke (OR = 2.51, 95% CI (1.75, 3.59), p < 0.00001), degree of stenosis (OR = 1.08, 95% CI (1.02, 1.14), p = 0.008), and an operation time window of less than two weeks (OR = 3.78, 95% CI (1.83, 7.82), p = 0.0003) constituted risk factors for CHS following carotid revascularization. Conversely, robust collateral circulation served as a protective factor (OR = 0.20, 95% CI (0.10, 0.42), p < 0.0001). Other factors such as male gender (OR = 1.02, 95% CI (0.63, 1.65), p = 0.93), hypertension (OR = 1.23, 95% CI (0.77, 1.96), p = 0.39), hyperlipidemia (OR = 1.18, 95% CI (0.70, 2.00), p = 0.54), prior alcohol consumption (OR = 0.99, 95% CI (0.62, 1.60), p = 0.98), smoking history (OR = 0.82, 95% CI (0.41, 1.64), p = 0.58), intraoperative hypertension (OR = 1.73, 95% CI (0.77, 3.88), p = 0.18), and post-operative hypertension (OR = 2.81, 95% CI (0.32, 24.33), p = 0.35) showed no significant association with post-revascularization CHS.
Conclusions:
This investigation elucidated the risk and protective factors for CHS after carotid artery revascularization. Further research and clinical application will aid in refining strategies for the prevention and management of CHS.
More Related Videos
09:11Performing Permanent Distal Middle Cerebral with Common Carotid Artery Occlusion in Aged Rats to Study Cortical Ischemia with Sustained Disability
Published on: February 23, 2016
06:10A Rat Model of Middle Cerebral Artery Occlusion/Reperfusion Without Damaging the Anatomical Structure of Cerebral Vessels
Published on: May 17, 2024
