title: Cerebral hyperperfusion after carotid stenting: a transcranial doppler and SPECT study.
abstract: OBJECTIVE
  To document the incidence of symptomatic cerebral hyperperfusion after carotid stenting and to determine possible predisposing factors.
  
  
  METHODS
  A prospective study of 29 consecutive patients undergoing carotid stenting. All patients underwent 1) brain computed tomography scan and magnetic resonance imaging, 2) transcranial Doppler including assessment of cerebrovascular reactivity of the ipsilateral middle cerebral artery and 3) 99m hexamethyl-propyleneamine oxime brain single photon emission computed tomography, before and after the procedure.
  
  
  RESULTS
  A total of 5 patients developed adverse neurological events, 4 of them transient. Cerebral hyperperfusion was documented in two of these (6.9%). Both had exhausted cerebrovascular reactivity in the preoperative transcranial Doppler examination. No consistent pattern of interhemispheric asymmetry in brain perfusion was found in these patients.
  
  
  CONCLUSIONS
  Symptomatic cerebral hyperperfusion is not uncommon after carotid stenting. There seems to be a link between exhausted cerebrovascular reactivity of the ipsilateral middle cerebral artery and increased risk of cerebral hyperperfusion.
authors.affiliation: 5th Surgical Clinic, Medical School, Aristotle University of Thessaloniki, Ippocrateio Hospital, Thessaloniki, Greece. gsfyr@yahoo.gr
authors.forename: Giorgos S
authors.initials: GS
authors.lastname: Sfyroeras
authors.forename: Christos D
authors.initials: CD
authors.lastname: Karkos
authors.forename: Georgios
authors.initials: G
authors.lastname: Arsos
authors.forename: Charalampos
authors.initials: C
authors.lastname: Liasidis
authors.forename: Athanassios S
authors.initials: AS
authors.lastname: Dimitriadis
authors.forename: Konstantinos O
authors.initials: KO
authors.lastname: Papazoglou
authors.forename: Thomas S
authors.initials: TS
authors.lastname: Gerassimidis
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017130:Angioplasty / Q000009:adverse effects* / Q000295:instrumentation*; D016893:Carotid Stenosis / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D002560:Cerebrovascular Circulation; D002561:Cerebrovascular Disorders / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D020768:Middle Cerebral Artery / Q000000981:diagnostic imaging / Q000503:physiopathology; D011237:Predictive Value of Tests; D011446:Prospective Studies; D019275:Radiopharmaceuticals; D018570:Risk Assessment; D012307:Risk Factors; D015607:Stents; D019690:Technetium Tc 99m Exametazime; D015899:Tomography, Emission-Computed, Single-Photon; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D017585:Ultrasonography, Doppler, Transcranial
chemical_list: D019275:Radiopharmaceuticals; D019690:Technetium Tc 99m Exametazime