T Mori1, M Fukuoka, K Kazita, T Mima, K Mori. 1. Department of Neurosurgery, Kochi Medical School Hospital, Okoutyo, Nankoku City, Japan. morit-koc@umin.ac.jp
Abstract
PURPOSE: To report an important complication related to carotid stenting. METHODS AND RESULTS: A 71-year-old man with symptomatic subtotal occlusion of the left internal carotid artery had a 30-mm lesion treated percutaneously with implantation of 2 stents. Although the procedure was completed satisfactorily, left intraventricular hemorrhage occurred 4 hours later, possibly related to hyperperfusion injury. The patient expired 30 days after the stent procedure. Preoperative single-photon emission computed tomography revealed severely reduced vasoreactivity in the affected territory after acetazolamide challenge. CONCLUSIONS: The risk of hyperperfusion injury must be considered and minimized in patients with significant restriction of regional vasoreactivity. We recommend that cerebral hemodynamic status be determined prior to carotid stenting.
PURPOSE: To report an important complication related to carotid stenting. METHODS AND RESULTS: A 71-year-old man with symptomatic subtotal occlusion of the left internal carotid artery had a 30-mm lesion treated percutaneously with implantation of 2 stents. Although the procedure was completed satisfactorily, left intraventricular hemorrhage occurred 4 hours later, possibly related to hyperperfusion injury. The patient expired 30 days after the stent procedure. Preoperative single-photon emission computed tomography revealed severely reduced vasoreactivity in the affected territory after acetazolamide challenge. CONCLUSIONS: The risk of hyperperfusion injury must be considered and minimized in patients with significant restriction of regional vasoreactivity. We recommend that cerebral hemodynamic status be determined prior to carotid stenting.
Authors: D S Chadha; Navreet Singh; A K Tewari; R S V Kumar; K K Yadav; A J Naveen; Manish Bhartiya; Vijay Kumar Gupta; Amit Wagh; A K Ghosh Journal: Med J Armed Forces India Date: 2013-12-16