Prediction of cerebral hyperperfusion after carotid artery stenting by cerebral angiography and single-photon emission computed tomography without acetazolamide challenge

Tsuyoshi Ohta, Ichiro Nakahara, Shoji Matsumoto, Ryota Ishibashi, Haruka Miyata, Hidehisa Nishi, Sadayoshi Watanabe, Izumi Nagata

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Background: Definitive preoperative predictors of cerebral hyperperfusion following carotid artery stenting are yet to be established. Objective: To determine the preprocedural risk factors for cerebral hyperperfusion phenomenon (CHP) following carotid artery stenting. Methods: Patients undergoing preprocedural single-photon emission computed tomography (SPECT) and cerebral angiography prior to their first carotid artery stenting were monitored for occurrence of CHP. In addition to patient characteristics, we investigated imaging parameters, such as cerebral blood flow, cerebral vasoreactivity, and asymmetry index on SPECT, and presence of near occlusion and leptomeningeal anastomosis on cerebral angiography. Results: Out of 100 patients (mean age: 73.0 ± 7.6 years; 85 men), 9 developed CHP. On multivariate logistic regression analysis, asymmetry index (%) on SPECT (odds ratio [OR] 0.81, 95% confidence interval [CI] 0.70-0.93, P = .003) and presence of leptomeningeal anastomosis on cerebral angiography (OR 72.1, 95% CI 3.52-1480, P = .006) were independent predictors of CHP. Conclusion: Combined use of cerebral angiography and SPECT may obviate the need for acetazolamide challenge to predict the risk of CHP following carotid artery stenting.

Original languageEnglish
Pages (from-to)512-519
Number of pages8
JournalNeurosurgery
Volume81
Issue number3
DOIs
Publication statusPublished - 01-09-2017

All Science Journal Classification (ASJC) codes

  • Surgery
  • Clinical Neurology

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