Gonzalez Garcia, AlejandroMoniche, FranciscoEscudero-Martinez, IreneMancha, FernandoTomasello, AlejandroRibo, MarcDelgado-Acosta, FernandoOchoa, Juan Josede Las Heras, Jose ALopez-Mesonero, LuisGonzalez-Delgado, MontserratMurias, EduardoGil, JoaquinGil, RosarioZamarro, JoaquinParrilla, GuillermoMosteiro, SoniaFernandez-Couto, Maria DoloresFernandez de Alarcon, LuisRamirez-Moreno, Jose MLuna, AlainGil, AlbertoGonzalez-Mandly, AndresCaniego, Jose LZapata-Wainberg, GustavoGarcia, ErnestoAlcazar, Pedro POrtega, JoaquinArenillas, Juan FAlgaba, PilarZapata-Arriaza, ElenaAlcalde-Lopez, Jesusde Alboniga-Chindurza, AsierCayuela, AurelioMontaner, Joan2023-01-252023-01-252019-05-19González 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):873-882http://hdl.handle.net/10668/13934The 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.encarotidhyperperfusionstentAge FactorsAgedAged, 80 and overCarotid StenosisCerebrovascular CirculationCerebrovascular DisordersConsciousness DisordersEndovascular ProceduresFemaleHeadacheHemodynamicsHumansMaleMiddle AgedProspective StudiesRenal Insufficiency, ChronicRisk AssessmentRisk FactorsSeizuresSeverity of Illness IndexSex FactorsSpainStentsTime FactorsTreatment Outcomeresearch article31072509Restricted AccessArterias carótidasSíndromeCefaleaFallo renal crónicoAngioplastiaHemorragiaAnálisis multivarianteInsuficiencia renal crónica10.1016/j.jcin.2019.01.2471876-7605https://doi.org/10.1016/j.jcin.2019.01.247