Angioplasty - Var. Techniques, Challs. in Trtmt. of Congen., by T. Forbes

By T. Forbes

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Cerebral perfusion patterns in patients with extracranial carotid atherosclerosis and the impact of carotid stenting. A review. J Cardiovasc Surg (Torino) 2008. ; Kouskouras, K & Gerassimidis, TS. The impact of carotid stenting on the hemodynamic parameters and cerebrovascular reactivity of the ipsilateral middle cerebral artery. J Vasc Surg. 2006 Nov; 44(5):1016-22; discussion 1022. ; Karkos, CD & Gerassimidis, TS. Cerebral perfusion patterns in patients with extracranial carotid atherosclerosis and the impact of carotid stenting.

Therefore, the pathophysiology of this type of ICH might differ from that of CHS, being closer to that of hypertensive ICH, in this case due to rupture of small perforating arteries in the basal ganglia after acute exposure to suddenly normalized perfusion pressure after angioplasty of a high grade stenosis. Brantley et al (2009) reported a patient with a nearly occlusive ICA stenosis who developed a fatal ipsilateral ICH immediately after the intervention; ICH was due to hemorrhagic conversion of a prior stroke.

Acta Neurochir (Wien) 1991; 112: 8-12. ; Ross Fleming, JF & Deck, JH. Cerebral hyperperfusion after carotid endarterectomy: a cause of cerebral hemorrhage. Neurosurgery 1984; 15: 50-6. S. ; Franklin & Davies,AH. Hypertension and the Post-carotid Endarterectomy Cerebral Hyperperfusion Syndrome. ; Gross, WS & Stanley, JC. Hypotension and hypertension as consequences of baroreceptor dysfunction following carotid endarterectomy. Surgery 1979; 85: 633-7. ; Milteer, HB Jr & Mendelsohn, FO. Hyperperfusion syndrome following carotid artery stenting: thelargest single-operator series to date.

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