Abstrato

Analysis on risk factors for cerebral hyperperfusion syndrome following carotid angioplasty stenting in the elderly patients with carotid artery stenosis and intervention measures

Rui Wang, Shuangchun Sun, Xinxin Fan

Objective: To study the risk factors for Cerebral Hyperperfusion Syndrome (CHS) following Carotid Angioplasty Stenting (CAS) in the elderly patients with carotid artery stenosis and to explore the intervention measures for prevention and treatment of CHS.

Methods: A total of 500 elderly patients with carotid artery stenosis enrolled in our hospital from May 2012 to May 2017 were selected as the objects. They all were treated with CAS, and divided according to presence of CHS into non CHS group (n=482) and CHS group (n=18), general data of patients were compared between the two groups, and independent risk factors were analysed by stratified method.

Results: The Univariate analysis showed that there was statistically significant difference between CHS group and non CHS group in diabetes and postoperative hypertension (P<0.05); but not in age, sex, hypertension, hyperlipidemia, ischemic events, drinking history as well as degree of stenosis (P>0.05). CAS was performed on 532 cases in the two groups, including 18 cases in CHS group and 514 cases in non CHS group. There was no statistically significant difference between the two groups in operative MCA occlusion, operative PCoA opening, symptomatic focus, and operative ACAA1 segment dysgenesis (P>0.05). The stratified analysis showed that postoperative hypertension (OR=7.248, P<0.01) and diabetes mellitus (OR=5.906, P<0.01) were important risk factors for CHS after CAS.

Conclusion: In elderly patients with carotid artery stenosis, those with postoperative hypertension or diabetes history are more prone to CHS following CAS with poor prognosis, which should be controlled and prevented from a variety of perspectives through intervention measures.