scholarly journals Isolated Intraventricular Hemorrhage after Carotid Artery Stenting

2021 ◽  
Vol 39 (3) ◽  
pp. 188-191
Author(s):  
Jiyong Shin ◽  
Jihee Ko ◽  
Minju Kim ◽  
Chul-Hoo Kang ◽  
Jay Chol Choi ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Carotid Artery ◽  
Pressure Fluctuation ◽  
Carotid Artery Stenting ◽  
Intraventricular Hemorrhage ◽  
Rare Complication ◽  
Hyperperfusion Syndrome ◽  
Blood Pressure Fluctuation

Cerebral intraventricular hemorrhage (IVH) is an extremely rare complication of carotid artery stenting (CAS). Fully dilated terminal arteries of a chronic, severely stenosed proximal artery could be ruptured by impaired autoregulation of cerebral blood flow. Hyperperfusion syndrome can occur even if there is no blood pressure fluctuation during the CAS. We report a case of an isolated IVH that occurred hours after CAS.

Fluctuating Blood Pressure and Intraventricular Hemorrhage

PEDIATRICS ◽  
1990 ◽  
Vol 85 (4) ◽  
pp. 621-622
Author(s):  
VIVIENNE MIALL-ALLEN
Keyword(s):  
Blood Pressure ◽  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Pressure Fluctuation ◽  
Blood Flow Velocity ◽  
Coefficient Of Variation ◽  
Intraventricular Hemorrhage ◽  
Recent Article ◽  
Cerebral Blood Flow Velocity ◽  
Blood Pressure Fluctuation

In Reply.— We would like to thank JM Perlman and JJ Volpe for their comments on our recent article.1 They were surprised that we did not observe the "excessive" levels of blood pressure fluctuation (coefficient of variation up to 30% or more) which they obtained for cerebral blood flow velocity in infants at greatest risk of developing IVH (Perlman et al2,3). We were surprised by this too; and, as we commented in the discussion, this disparity is difficult to explain.

Global Oxygen Extraction Fraction by Blood Sampling to Anticipate Cerebral Hyperperfusion Phenomenon After Carotid Artery Stenting

Neurosurgery ◽  
2014 ◽  
Vol 75 (5) ◽  
pp. 546-551 ◽  
Author(s):  
Tomonori Iwata ◽  
Takahisa Mori ◽  
Yuichi Miyazaki ◽  
Yuhei Tanno ◽  
Shigen Kasakura ◽  
...  
Keyword(s):  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Carotid Artery ◽  
Carotid Artery Stenting ◽  
Blood Sampling ◽  
Oxygen Extraction Fraction ◽  
Cerebral Hyperperfusion Syndrome ◽  
Hyperperfusion Syndrome ◽  
Cerebral Hyperperfusion ◽  
Extraction Fraction

Abstract BACKGROUND: Cerebral hyperperfusion syndrome sometimes occurs after carotid revascularization in patients with severe hemodynamic failure. To prevent cerebral hyperperfusion syndrome, cerebral hyperperfusion phenomenon (CHP) must be detected early. Single-photon emission computed tomography (SPECT) is useful for detecting CHP, but it is impractical on a daily basis. A tool with high availability to find CHP is desired. OBJECTIVE: To investigate whether global oxygen extraction fraction (OEF) by a blood sampling method is useful for indicating CHP after carotid artery stenting (CAS). METHODS: When patients underwent elective CAS from September 2010 to August 2012, we performed blood sampling for OEF calculation and SPECT before and immediately after elective CAS. Data were collected prospectively. OEF was calculated from the cerebral arteriovenous oxygen difference. Cerebral blood flow was measured in the affected middle cerebral artery (MCA) territory and in the ipsilateral cerebellum by SPECT. The ratio of MCA to cerebellar activity was defined as cerebral blood flow in the affected MCA territory divided by cerebral blood flow in the ipsilateral cerebellar hemisphere. Probable CHP was defined as ≥10% increase in the ratio of MCA to cerebellar activity after CAS. The relationship between peri-CAS OEF and probable CHP was evaluated. RESULTS: Of the 96 patients enrolled, 92 patients were analyzed. Probable CHP occurred in 17 patients. Post-CAS OEF was related to probable CHP (P < .01), but pre-CAS OEF was not. The receiver-operating characteristic curve showed that the cutoff value was 45% for probable CHP (P < .001). CONCLUSION: An increase in blood sampling OEF immediately after CAS was related to probable CHP; then the oxygen demand should be reduced.

scholarly journals Correlation between Higher Brain Dysfunction and Cerebral Blood Flow after Carotid Artery Stenting

2021 ◽  
Author(s):  
Ryousuke Orimoto ◽  
Eiichi Kobayashi ◽  
Midori Abe ◽  
Akihiko Adachi ◽  
Yoichi Yoshida ◽  
...  
Keyword(s):  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Carotid Artery ◽  
Carotid Artery Stenting ◽  
Brain Dysfunction ◽  
Higher Brain Dysfunction

Intracranial hemorrhage associated with cerebral hyperperfusion syndrome following carotid endarterectomy and carotid artery stenting: retrospective review of 4494 patients

2007 ◽  
Vol 107 (6) ◽  
pp. 1130-1136 ◽  
Author(s):  
Kuniaki Ogasawara ◽  
Nobuyuki Sakai ◽  
Terumasa Kuroiwa ◽  
Kohkichi Hosoda ◽  
Koji Iihara ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Carotid Artery ◽  
Carotid Endarterectomy ◽  
Intracranial Hemorrhage ◽  
Carotid Artery Stenting ◽  
Clinicopathological Features ◽  
Cerebral Hyperperfusion Syndrome ◽  
Hyperperfusion Syndrome ◽  
Cerebral Hyperperfusion ◽  
Postoperative Control

Object Intracranial hemorrhage associated with cerebral hyperperfusion syndrome (CHS) following carotid endarterectomy (CEA) or carotid artery stenting (CAS) is a rare but potentially devastating complication. In the present study the authors evaluated 4494 patients with carotid artery stenosis who had undergone CEA or CAS to clarify the clinicopathological features and outcomes of those with CHS and associated intracranial hemorrhage. Methods Patients with postoperative CHS were retrospectively selected, and clinicopathological features and outcomes were studied. Results Sixty-one patients with CHS (1.4%) were identified, and intracranial hemorrhage developed in 27 of them (0.6%). The onset of CHS peaked on the 6th postoperative day in those who had undergone CEA and within 12 hours in those who had undergone CAS. Results of logistic regression analysis demonstrated that poor postoperative control of blood pressure was significantly associated with the development of intracranial hemorrhage in patients with CHS after CEA (p = 0.0164). Note, however, that none of the tested variables were significantly associated with the development of intracranial hemorrhage in patients with CHS after CAS. Mortality (p = 0.0010) and morbidity (p = 0.0172) rates were significantly higher in patients with intracranial hemorrhage than in those without. Conclusions Cerebral hyperperfusion syndrome after CEA and CAS occurs with delayed classic and acute presentations, respectively. Although strict control of postoperative blood pressure prevents intracranial hemorrhage in patients with CHS after CEA, there appears to be no relationship between blood pressure control and intracranial hemorrhage in those with CHS after CAS. Finally, the prognosis of CHS in patients with associated intracerebral hemorrhage is poor.

scholarly journals Features of cerebral blood flow in patients with chronic obstructive pulmonary disease associated with hypertension

2021 ◽  
Vol 26 (6) ◽  
pp. 676-687
Author(s):  
N. B. Poletaeva ◽  
O. V. Teplyakova ◽  
I. F. Grishina ◽  
A. A. Klepikova
Keyword(s):  
Blood Pressure ◽  
Chronic Obstructive Pulmonary Disease ◽  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Carotid Artery ◽  
Blood Flow Velocity ◽  
Flow Index ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Blood Flow Index

Objective. The aim of the work was to study the features of cerebral blood flow in patients with chronic obstructive pulmonary disease (COPD) associated with hypertension (HTN). Design and methods. A crosssectional study was conducted, which included 90 males 40–60 years old. Of these, 30 patients with chronic COPD associated with HTN (COPD + HTN) were included in the study group, 30 individuals with isolated COPD were in the comparison group, 30 healthy volunteers were included in the control group. All participants underwent physical examination, spirography, 24-hour blood pressure monitoring and ultrasound examination of cerebral vessels. Results. Patients with COPD + HTN in comparison with the control showed an increase in the diameter (p = 0,018) and complex of the intima-media of the common carotid artery (p = 0,003) while the velocities, resistance index (RI) and pulsation index (PI) did not change. In the basin of the internal carotid artery an increase in RI values was noted (p = 0,018). At the intracranial level there was a decrease in the end-diastolic velocity (p = 0,03) and the time-averaged average blood flow velocity (TAV) (p = 0,033) without due changes RI and PI. At the same time no changes in speed indicators and indices were noted in the vertebral artery basin. Among the indicators of cerebral perfusion in patients with COPD + HTN, hydrodynamic resistance (p = 0,0015), intracranial pressure (ICP) (p = 0,0048) significantly increased, and the cerebral blood flow index was comparable with the control. Assessment of venous cerebral blood flow showed an increase in the diameter of the internal jugular vein (p = 0,021) with unchanged TAV together with an increase in ICP indicating the formation of venous dysfunction. It was shown that the body mass index, forced expiratory volume at the first second, systolic and diastolic blood pressure together determine the peak systolic blood flow velocity from the midbrain artery. Conclusions. The cerebral blood flow in patients with COPD + HTN is characterized by a change in arterial blood flow at the level of both intra- and extracranial vessels, while maintaining a normal cerebral blood flow index, as well as the formation of arteriovenous dyshemia against the background of remodeling of the cerebral vascular bed.

scholarly journals New-onset lesions on MRI-DWI and cerebral blood flow changes on 3D-pCASL after carotid artery stenting

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Wen-Xin Wang ◽  
Ting Wang ◽  
Lin Ma ◽  
Zheng-Hui Sun ◽  
Ge-Sheng Wang ◽  
...  
Keyword(s):  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Carotid Artery ◽  
Carotid Artery Stenting ◽  
Three Dimensional ◽  
Diffusion Weighted Images ◽  
Parietal Lobes ◽  
Before And After ◽  
Continuous Arterial Spin Labeling ◽  
New Onset

AbstractThis study aimed to investigate the relationship between the new-onset hyperintense lesions on diffusion-weighted images (DWI) and the changes of cerebral blood flow (CBF) before and after carotid artery stenting (CAS) in patients with symptomatic unilateral carotid artery stenosis. Twenty-four patients with symptomatic unilateral carotid stenosis (50–99%) were enrolled. Routine head magnetic resonance imaging and three-dimensional pseudo-continuous arterial spin labeling were taken 7 days before the surgery and for four consecutive days post CAS. While the incidence of new DWI lesions were high (17/24, 70.8%) and 176 lesions were observed among the 17 cases, there was only one subject showing the symptoms. The majority of the lesions were located at the cortex/subcortex of the ipsilateral frontal and parietal lobes (60.8%) with 92.6% of the lesions size being less than 3 mm. The CBFs in this area were significantly higher than that of the temporal lobe on the first 3 days post stenting (p < 0.05). No periprocedural CBF differences were observed between the two groups, however, the micro-embolism group presented decreased relative CBF in frontal and parietal lobes prior to stenting compared with the non-embolism group. The systolic blood pressure in the micro-embolism group at discharge was significantly lower than that at admission. The high incidence rate of micro-embolism in patients receiving CAS may not be the result of direct changes of hemodynamics in the brain but rather the loss of CBF regulation due to long-term hypoperfusion prior to the stenting.

scholarly journals Evaluation of cerebral blood flow by transcranial Doppler after carotid artery stenting

Neurosonology ◽  
2008 ◽  
Vol 21 (1) ◽  
pp. 18-21
Author(s):  
Kei HARADA ◽  
Shoichi KATO ◽  
Hideyuki ISHIHARA ◽  
Tetsu KUROKAWA ◽  
Fumiaki OKA ◽  
...  
Keyword(s):  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Carotid Artery ◽  
Transcranial Doppler ◽  
Carotid Artery Stenting

scholarly journals Effects of Shift Work on the Carotid Artery and Cerebral Blood Flow of Spontaneously Hypertensive Rats and Wistar-Kyoto Rats

2019 ◽  
Author(s):  
YunLei Wang ◽  
Tong Zhang ◽  
YuGe Zhang ◽  
Yan Yu ◽  
Fan Bai ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Carotid Artery ◽  
Shift Work ◽  
Arterial Thrombosis ◽  
Carotid Arteries ◽  
Elevated Blood Pressure ◽  
Elevated Blood ◽  
Carotid Arterial

AbstractObjectiveThe objective was to investigate the effects of shift-work (SW) on the carotid arteries.MethodsThis study used two inverted photoperiods (inverted light:dark [ILD]16:8 and ILD12:12) to create the SW model. We recorded the rhythm and performed serological tests, carotid ultrasound, magnetic resonance imaging, and carotid biopsy.ResultsSW induced elevated blood pressure and increased angiotensin-II, apolipoprotein E, blood glucose, and triglycerides. SW increased the carotid intima-media thickness. SW led to the development of carotid arterial thrombosis, reduced cerebral blood flow, and increased the number of collagen fibers, expression of angiotensin receptor and low-density lipoprotein receptor in the carotid arteries. SW decreased 3-hydroxy-3-methylglutaryl-CoA reductase and nitric oxide. SW induced the atherosclerotic plaque in the aorta. Multiple results of SHR were worse than WKY rats.ConclusionSW can induce metabolic disorders and elevated blood pressure. SW can cause intima-media thickening of the carotid artery and aorta atherosclerosis. SW may result in carotid arterial thrombosis and affect cerebral blood flow. Hypertension can aggravate the adverse effects of SW.

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