%0 Journal Article
%A Gonzalez Garcia, Alejandro
%A Moniche, Francisco
%A Escudero-Martinez, Irene
%A Mancha, Fernando
%A Tomasello, Alejandro
%A Ribo, Marc
%A Delgado-Acosta, Fernando
%A Ochoa, Juan Jose
%A de Las Heras, Jose A
%A Lopez-Mesonero, Luis
%A Gonzalez-Delgado, Montserrat
%A Murias, Eduardo
%A Gil, Joaquin
%A Gil, Rosario
%A Zamarro, Joaquin
%A Parrilla, Guillermo
%A Mosteiro, Sonia
%A Fernandez-Couto, Maria Dolores
%A Fernandez de Alarcon, Luis
%A Ramirez-Moreno, Jose M
%A Luna, Alain
%A Gil, Alberto
%A Gonzalez-Mandly, Andres
%A Caniego, Jose L
%A Zapata-Wainberg, Gustavo
%A Garcia, Ernesto
%A Alcazar, Pedro P
%A Ortega, Joaquin
%A Arenillas, Juan F
%A Algaba, Pilar
%A Zapata-Arriaza, Elena
%A Alcalde-Lopez, Jesus
%A de Alboniga-Chindurza, Asier
%A Cayuela, Aurelio
%A Montaner, Joan
%T Clinical Predictors of Hyperperfusion Syndrome Following Carotid Stenting: Results From a National Prospective Multicenter Study.
%D 2019
%U http://hdl.handle.net/10668/13934
%X The aim of the HISPANIAS (HyperperfusIon Syndrome Post-carotid ANgIoplasty And Stenting) study was to define CHS rates and develop a clinical predictive model for cerebral hyperperfusion syndrome (CHS) after carotid artery stenting (CAS). CHS is a severe complication following CAS. The presence of clinical manifestations is estimated on the basis of retrospective reviews and is still uncertain. The HISPANIAS study was a national prospective multicenter study with 14 recruiting hospitals. CHS was classified as mild (headache only) and moderate-severe (seizure, impaired level of consciousness, or development of focal neurological signs). A total of 757 CAS procedures were performed. CHS occurred in 22 (2.9%) patients, in which 16 (2.1%) had moderate-severe CHS and 6 (0.8%) had mild CHS (only headache). The rate of hemorrhages was 0.7% and was associated with high mortality (20%). Pre-operative predictors of moderate-severe CHS in multivariate analysis were female sex (odds ratio [OR]: 3.24; 95% confidence interval [CI]: 1.11 to 9.47; p = 0.03), older patients (OR: 1.09; 95% CI: 1.01 to 1.17; p = 0.02), left carotid artery treated (OR: 4.13; 95% CI: 1.11 to 15.40; p = 0.03), and chronic renal failure (OR: 6.29; 95% CI: 1.75 to 22.57; p = 0.005). The area under the curve of this clinical and radiological model was 0.86 (95% CI: 0.81 to 0.92; p = 0.001). The rate of CHS in the HISPANIAS study was 2.9%, with moderate-severe CHS of 2.1%. CHS was independently associated with female sex, older age, history of chronic kidney disease, and a treated left carotid artery. Although further investigations are needed, the authors propose a model to identify high-risk patients and develop strategies to decrease CHS morbidity and mortality in the future.
%K carotid
%K hyperperfusion
%K stent
%~