Intraventricular hemorrhage after carotid stenting.
OBJECTIVE
To report an important complication related to carotid stenting.


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.
Mori
T
T
Department of Neurosurgery, Kochi Medical School Hospital, Okoutyo, Nankoku City, Japan. morit-koc@umin.ac.jp
Fukuoka
M
M
Kazita
K
K
Mima
T
T
Mori
K
K
D000368:Aged; D000800:Angioplasty, Balloon / Q000009:adverse effects*; D002343:Carotid Artery, Internal; D016893:Carotid Stenosis / Q000175:diagnosis / Q000628:therapy*; D002533:Cerebral Angiography; D002543:Cerebral Hemorrhage / Q000175:diagnosis / Q000209:etiology*; D002552:Cerebral Ventricles; D017809:Fatal Outcome; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D015607:Stents / Q000009:adverse effects*; D015899:Tomography, Emission-Computed, Single-Photon