title: [Risk analysis for cerebral hyperperfusion syndrome after carotid endarterectomy].
abstract: OBJECTIVE
  To analyze risk factors for cerebral hyperperfusion syndrome (CHS) after carotid endarterectomy (CEA).
  
  
  METHODS
  From September 2010 to September 2012, 183 consecutive patients with carotid artery stenosis who had indications for CEA entered the study. There were 149 male and 34 female patients, aged from 38 to 83 years with an average of (66 ± 9) years. Intracranial blood flow changes were monitored through transcranial Doppler routinely. Pre- and post-operative middle cerebral artery velocity (VMCA) were recorded. CHS was diagnosed by the combination of hyperperfusion syndrome and 100% increase of VMCA after operation compared with pre-operative baseline values. The patients who had CHS during hospitalization were recorded. Pre-operative and operative related factors were analyzed by univariate analysis, followed by Logistic regression model, to identify the risk factors of CHS.
  
  
  RESULTS
  Overall, CHS occurred in 15 patients (8.2%) after CEA. The average onset time was (2.6 ± 0.2) days after surgery. By decreasing blood pressure and using dehydration medicine, all the patients with CHS recovered before discharge. None of them developed to intracranial hemorrhage. On univariate analysis, significant risk factors for CHS were history of stoke, symptomatic carotid artery stenosis and shunting during operation. On Logistic regression model, independent risk factor was symptomatic carotid artery stenosis (OR = 6.733, 95%CI: 1.455-31.155, P = 0.015), while shunting during operation (OR = 0.252, 95%CI: 0.067-0.945, P = 0.041) was a protective factor.
  
  
  CONCLUSIONS
  Symptomatic carotid artery stenosis is an independent risk factor for CHS after CEA and shunting during operation is a protective factor. Using shunt may be an effective method of preventing CHS after CEA.
authors: Department of Vascular Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Peking Union Medical College, Beijing 100730, China.
authors: Leng
authors: L
authors: Ni
authors: Department of Vascular Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Peking Union Medical College, Beijing 100730, China. Email: liucw@vip.sina.com.
authors: Chang-Wei
authors: CW
authors: Liu
authors: Department of Vascular Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Peking Union Medical College, Beijing 100730, China.
authors: Li-Ying
authors: LY
authors: Cui
authors: Department of Vascular Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Peking Union Medical College, Beijing 100730, China.
authors: Bao
authors: B
authors: Liu
authors: Department of Vascular Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Peking Union Medical College, Beijing 100730, China.
authors: Wei
authors: W
authors: Ye
authors: Department of Vascular Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Peking Union Medical College, Beijing 100730, China.
authors: Shan
authors: S
authors: Gao
authors: Department of Vascular Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Peking Union Medical College, Beijing 100730, China.
authors: Ying-Huan
authors: YH
authors: Hu
authors: Department of Vascular Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Peking Union Medical College, Beijing 100730, China.
authors: Zhi-Chao
authors: ZC
authors: Lai
mesh_terms: D016893:Carotid Stenosis / Q000601:surgery; D016894:Endarterectomy, Carotid; D006801:Humans; D020768:Middle Cerebral Artery; D018570:Risk Assessment; D012307:Risk Factors