title: Evaluation of Cerebral Hyperperfusion After Carotid Artery Stenting Using C‑Arm CT Measurements of Cerebral Blood Volume.
abstract: OBJECTIVE
  Hyperperfusion syndrome (HPS) after carotid artery stenting (CAS) causes serious symptoms; therefore, early evaluation after CAS is considered to be important. Measurement of cerebral blood volume using C‑arm computed tomography (C-arm CBV) has recently become possible. Here, the usefulness of C‑arm CBV for the evaluation of hyperperfusion was investigated.
  
  
  METHODS
  C-arm CBV was measured before and immediately after CAS in 30 patients. The regions of interest (ROI) were set in the bilateral middle cerebral artery perfused regions, and the affected/healthy side ratio of measured C‑arm CBV (CBV ratios) was determined to evaluate cerebral perfusion. For comparing values before and after CAS, the CBV ratio increase rate (postoperative CBV ratios/preoperative CBV ratios) was also determined.
  
  
  RESULTS
  C-arm CBV was successfully measured in 30 patients. Intracerebral hemorrhage (ICH) was detected in 3 patients, and no other patient had hyperperfusion syndrome. In the patients who developed ICH, postoperative C‑arm CBV on the affected side was high, and a marked increase was confirmed in the postoperative CBV ratios. Postoperative CBV ratios were 1.03 ± 0.40 and 1.45 ± 0.68 in the non-ICH and ICH groups, and CBV ratio increase rates were 2.7 ± 24.0% and 28.5 ± 26.7% in the non-ICH and ICH groups, respectively; these differences were statistically significant (P < 0.01).
  
  
  CONCLUSIONS
  C-arm CT allows CBV measurements immediately after CAS without requiring transport of the patient out of the angiography room, and it may enable the evaluation of hyperperfusion before and after CAS.
authors.affiliation: Department of Neurosurgery, Shin-yurigaoka General Hospital, 255 Furusawa Asao-ku, 215-0026, Kawasaki, Kanagawa, Japan. michio1974111@gmail.com.
authors.forename: Michio
authors.identifier: http://orcid.org/0000-0002-1752-7744
authors.initials: M
authors.lastname: Fujimoto
authors.affiliation: Department of Neurosurgery, Shin-yurigaoka General Hospital, 255 Furusawa Asao-ku, 215-0026, Kawasaki, Kanagawa, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Itokawa
authors.affiliation: Department of Neurosurgery, Shin-yurigaoka General Hospital, 255 Furusawa Asao-ku, 215-0026, Kawasaki, Kanagawa, Japan.
authors.forename: Masao
authors.initials: M
authors.lastname: Moriya
authors.affiliation: Department of Neurosurgery, Shin-yurigaoka General Hospital, 255 Furusawa Asao-ku, 215-0026, Kawasaki, Kanagawa, Japan.
authors.forename: Noriyoshi
authors.initials: N
authors.lastname: Okamoto
authors.affiliation: Department of Neurosurgery, Shin-yurigaoka General Hospital, 255 Furusawa Asao-ku, 215-0026, Kawasaki, Kanagawa, Japan.
authors.forename: Jinichi
authors.initials: J
authors.lastname: Sasanuma
mesh_terms: D000368:Aged; D002339:Carotid Arteries; D016893:Carotid Stenosis / Q000628:therapy*; D000071937:Cerebral Blood Volume; D002560:Cerebrovascular Circulation; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D015607:Stents; D014057:Tomography, X-Ray Computed
keywords: C-arm computed tomography; Carotid artery stenting; Cerebral blood volume; Hyperperfusion