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

This study sought to investigate the risk factors for cerebral hyperperfusion syndrome (CHS) after carotid artery interventional therapy, and to explore potential preventive measures. Three hundred and eighty-two patients treated with carotid artery stenting at the Huanhu Hospital (Tianjin, China) between January 2010 and January 2016 were divided into CHS and non-CHS groups. A retrospective analysis of patient clinical data was made. The CHS group had more patients presenting coronary heart disease, diabetes, progressive neurological disease and transient recurrent cerebral hemorrhage than the non-CHS group. More patients in the CHS group presented stenosis of the internal carotid artery siphon. More CHS group patients showed plaque formation extending >3 cm to the distal end of the internal carotid artery. Finally, more CHS group patients had pressure gradients >60 mmHg (p<0.05). Logistics regression analysis showed that preoperative diabetes mellitus and carotid pressure gradient ≥60 mmHg were independent risk factors for CHS (p<0.05). The ROC curve of carotid pressure gradients ≥60 mmHg were made to predict CHS, with the area under curve being 0.949 (p<0.05). The best cut-off value was 60 mmHg. Therefore, preoperative diabetes and a carotid pressure gradient ≥60 mmHg are risk factors for CHS, and these indicators need to be examined prior to operation.