Identifying Patients at Risk for Hyperperfusion after Carotid Stenting Using CT Perfusion with Acetazolamide Challenge

Hyperperfusion syndrome can occur in patients with preprocedural cerebral hemodynamic impairment who candidate for carotid stent. We investigated whether preprocedural measurement of cerebrovascular reserve (CVR) by using CT perfusion (CTP) with acetazolamide (ACZ) challenge could identify patients at risk for hyperperfusion after CS. For 12 patients with symptomatic unilateral or bilateral carotid stenosis (> 70%), hemodynamic parameters including cerebral blood volume (CBV), cerebral blood flow (CBF), mean transit time (MTT), and percent change of CBF were investigated before, 1 day and 3 months after CS, with resting and ACZ-challenged CTP. Normal percent changes of CBV, CBF, and MTT were determined in 12 age and sex-matched normal controls. On the qualitative CVR analysis, ipsilateral CBF increase on the first postprocedural day were not significantly different between the reduced and the normal CVR group (1.7 ± 3.6 % vs. 7.0 ± 10.9 %, P > 0.05). Three months later, this increase was almost normalized. On the quantitative CVR analysis, there was no significant correlation between the values of preprocedural CTP parameters and CBF increases in 1 day after CS, however quantitative CVR showed fair correlation with CBF increase. Maximum 1 day CBF increase was observed in the reduced CVR group. Hyperperfusion (CBF increase of > 100% compared with baseline values) was not observed in both reduced and normal CVR groups. The values of CTP parameters before CS were not significantly correlated with CBF increase 1 day after CS. Quantitative CVR showed fair correlation with the percent change of CBF 1 day after CS.

Author dc:creator

• 김, 은진

Contributors dc:contributor

• 김, 선용
• 대학원 의학과
• 105542

• CT perfusion
• carotid artery stenosis
• hyperperfusion

Language dc:language

en

Identifier

http://dcoll.ajou.ac.kr:9080/dcollection/jsp/common/DcLoOrgPer.jsp?sItemId=000000009130
000000009130

OAI identifier oai:identifier

oai:repository.ajou.ac.kr:201003/1344