颈动脉支架成形术后高灌注综合征临床分析

目的 探讨颈动脉支架成形术后高灌注综合征(HS)的临床特点及发生机制.方法 回顾性分析150例颈动脉支架成形术(12AS)后13例(8.7%)发生HS患者的临床资料.结果 本组患者术前颈动脉狭窄率平均为91%;术后15min～1周(平均2.5 h)均出现头痛(100%),其中伴高血压8例(61.5%)、癫癎部分性发作5例(38.5%)和局部神经功能缺损4例(30.8%).经颅多普勒(TCD)证实为支架侧大脑中动脉的峰血流增加≥100%.CT示有颅内出血4例,脑组织水肿7例,无明显异常2例.经控制血压、神经保护等治疗,7例完全恢复,4例部分恢复,2例死亡.结论 CAS术后HS主要表现为头痛、癫癎发作和局部神经功能缺损等脑出血及脑组织水肿表现,重度动脉狭窄可能是CAS术后HS的发病机制;术后TCD监测脑血流有助于及时诊断和治疗.

Clinical analysis of hyperperfusion syndrome after carotid artery stenting

Objective To explore the clinical characteristic and mechanism of hyperperfusion syndrome(HS) after carotid artery stenting(CAS).Methods The clinical data of 13 cases(8.7%) with HS in 150 patients performed CAS were analyzed retrospectively.Results In the 13 cases,the average rate of carotid artery stenosis was 91% before CAS.All of them had headache from 15 min to 1 week(average 2.5 h) after CAS,and 8 cases had hypertension(61.5%),5 cases had epilepsy partial seizures(38.5%) and 4 cases had local neurologi...