Ma Yuerong, Zhang Renwei, Liu Yumin
Department of Neurology, Zhongnan Hospital of Wuhan University, Wuhan, China.
Front Surg. 2023 Jan 9;9:1077826. doi: 10.3389/fsurg.2022.1077826. eCollection 2022.
Carotid artery stent implantation (CAS) plays an important role in preventing cerebral infarction associated with carotid stenosis. The postoperative complications of CAS include cerebral hyperperfusion syndrome (CHS), cerebral infarction, vascular injury, carotid sinus reaction, and stent restenosis. Hyperperfusion syndrome (CHS) is a serious complication that arises after the performance of carotid endarterectomy (CEA) or CAS and is characterized by high blood pressure, headache, epilepsy, and focal neurological deficit. Therefore, it is very important to evaluate and diagnose CHS. Cerebral infarction after CAS is often caused by distal embolism due to the shedding of microemboli. With the application of distal brain protection devices, the risk of distal embolism is significantly reduced. In this study, we report a rare case of hypoperfusion cerebral infarction after carotid artery stenting in a patient with severe carotid stenosis complicated with contralateral common carotid artery occlusion.
颈动脉支架植入术（CAS）在预防与颈动脉狭窄相关的脑梗死方面发挥着重要作用。CAS的术后并发症包括脑过度灌注综合征（CHS）、脑梗死、血管损伤、颈动脉窦反应和支架再狭窄。过度灌注综合征（CHS）是颈动脉内膜切除术（CEA）或CAS术后出现的一种严重并发症，其特征为高血压、头痛、癫痫和局灶性神经功能缺损。因此，评估和诊断CHS非常重要。CAS术后的脑梗死通常是由微栓子脱落导致的远端栓塞引起的。随着远端脑保护装置的应用，远端栓塞的风险显著降低。在本研究中，我们报告了1例严重颈动脉狭窄合并对侧颈总动脉闭塞患者在颈动脉支架置入术后发生低灌注性脑梗死的罕见病例。
