Pilz G, Klos M, Bernhardt P, Schöne A, Scheck R, Höfling B
Kardiologie am Krankenhaus Agatharied, Akademisches Lehrkrankenhaus der LMU München, St.-Agatha-Str. 1, 83734, Hausham, Germany.
Clin Res Cardiol. 2006 Mar;95(3):186-91. doi: 10.1007/s00392-006-0347-1. Epub 2006 Jan 12.
Hyperperfusion syndrome can complicate carotid revascularization, be it endarterectomy or carotid artery stenting (CAS). Although extensive effort has been devoted to reducing the incidence of ischemic stroke complicating CAS, little is known about the incidence, etiology, and prevention strategies for hyperperfusion following CAS. We report two cases (female patients 72 and 81 years) presenting severe internal carotid stenosis (> 90%), who underwent presurgical and therapeutic intervention with CAS. Both patients developed hyperperfusion symptoms at 2 hours and at 30 minutes, respectively, following stenting, in both cases unilateral hyperperfusion was CCT confirmed. Case 1 was presenting with acute edema of the right hemisphere, case 2 with distended focal edema (left fronto-temporoparietally). Hyperperfusion syndrome and neurological symptoms retroceded in both cases (conservative therapy) and both patients returned to full activity (case 2 within 48 hours).
高灌注综合征可使颈动脉血运重建复杂化，无论是内膜切除术还是颈动脉支架置入术（CAS）。尽管人们已付出巨大努力来降低CAS并发缺血性卒中的发生率，但对于CAS术后高灌注的发生率、病因及预防策略却知之甚少。我们报告两例（分别为72岁和81岁女性患者）患有严重颈内动脉狭窄（>90%）的病例，她们接受了CAS术前及治疗干预。两例患者分别在支架置入术后2小时和30分钟出现高灌注症状，经CCT证实均为单侧高灌注。病例1表现为右半球急性水肿，病例2表现为局灶性水肿（左额颞顶叶）。两例患者的高灌注综合征及神经症状均消退（保守治疗），且均恢复了正常活动（病例2在48小时内）。
