RT Journal Article
T1 Clinical Predictors of Hyperperfusion Syndrome Following Carotid Stenting: Results From a National Prospective Multicenter Study.
A1 Gonzalez Garcia, Alejandro
A1 Moniche, Francisco
A1 Escudero-Martinez, Irene
A1 Mancha, Fernando
A1 Tomasello, Alejandro
A1 Ribo, Marc
A1 Delgado-Acosta, Fernando
A1 Ochoa, Juan Jose
A1 de Las Heras, Jose A
A1 Lopez-Mesonero, Luis
A1 Gonzalez-Delgado, Montserrat
A1 Murias, Eduardo
A1 Gil, Joaquin
A1 Gil, Rosario
A1 Zamarro, Joaquin
A1 Parrilla, Guillermo
A1 Mosteiro, Sonia
A1 Fernandez-Couto, Maria Dolores
A1 Fernandez de Alarcon, Luis
A1 Ramirez-Moreno, Jose M
A1 Luna, Alain
A1 Gil, Alberto
A1 Gonzalez-Mandly, Andres
A1 Caniego, Jose L
A1 Zapata-Wainberg, Gustavo
A1 Garcia, Ernesto
A1 Alcazar, Pedro P
A1 Ortega, Joaquin
A1 Arenillas, Juan F
A1 Algaba, Pilar
A1 Zapata-Arriaza, Elena
A1 Alcalde-Lopez, Jesus
A1 de Alboniga-Chindurza, Asier
A1 Cayuela, Aurelio
A1 Montaner, Joan
K1 carotid
K1 hyperperfusion
K1 stent
AB 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.
PB American College of Cardiology
YR 2019
FD 2019-05-19
LK http://hdl.handle.net/10668/13934
UL http://hdl.handle.net/10668/13934
LA en
NO González García A, Moniche F, Escudero-Martínez I, Mancha F, Tomasello A, Ribó M, et al. Clinical Predictors of Hyperperfusion Syndrome Following Carotid Stenting: Results From a National Prospective Multicenter Study. JACC Cardiovasc Interv. 2019 May 13;12(9):873-882
DS RISalud
RD Apr 17, 2025