Fatal Cerebral Hemorrhage After Carotid Stenting
| Autor: | David Sai Wah Ho, Raymond T.F. Cheung |
|---|---|
| Rok vydání: | 2000 |
| Předmět: |
Advanced and Specialized Nursing
medicine.medical_specialty Percutaneous business.industry medicine.medical_treatment Stent Carotid endarterectomy Transluminal Angioplasty medicine.disease Stenosis Internal medicine medicine.artery Middle cerebral artery cardiovascular system medicine Cardiology cardiovascular diseases Neurology (clinical) Radiology Carotid stenting Internal carotid artery Cardiology and Cardiovascular Medicine business |
| Zdroj: | Stroke. 31:791-799 |
| ISSN: | 1524-4628 0039-2499 |
| DOI: | 10.1161/01.str.31.3.791-b |
| Popis: | To the Editor: Percutaneous transluminal angioplasty (PTA) and stenting are increasingly used as an alternative to carotid endarterectomy (CEA) for patients with carotid stenosis. Cerebral hyperperfusion syndrome following CEA has been widely reported in the surgical literature. It is timely that interventionists increase their awareness of such a syndrome, as it can also happen after PTA. In the case reported by McCabe et al.,1 however, there was really no objective documentation of hyperperfusion. Moreover, the case was not heralded by or associated with any of the typical symptoms of hyperperfusion syndrome, such as unilateral headache or seizures.2 The Doppler findings of increased peak systolic and end-diastolic velocity over the stented internal carotid artery (ICA) are even more puzzling. The authors postulated that hyperperfusion may manifest as increased flow velocity in the ICA. Instead of increased blood flow, we suspect that the turbulence is caused by a sharp bend of the right ICA immediately above the stent (see Figure 3 of McCabe et al), significant residual stenosis, or spasm. It would help if the authors could state the Doppler findings of the left and right ICA before the stenting procedure. Even if the flow volume to the middle cerebral artery (MCA) … |
| Databáze: | OpenAIRE |
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