Fatal cerebral hemorrhage early after subclavian artery endovascular therapy.

We report a case of cerebral hyperperfusion syndrome complicated by a fatal intracranial hemorrhage as a consequence of endovascular recanalization of an occluded left subclavian artery. This entity is thought to be secondary to the failure of the normal autoregulatory mechanism controlling cerebral blood flow after recanalization. Patients at risk for this relatively rare complication are not easily identified. Further investigation is warranted to identify patients at risk for this complication and to determine optimal periprocedural management to decrease risk.