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Left to Right Ratio of Transcranial Color-coded Sonography for Monitoring Hyperperfusion Syndrome after Carotid Artery Stenting: A Case Report Kenichi KONO 1 , Yoshiyuki WAKUGAWA 2 , Ken UDA 3 , Masahiro YASAKA 2 , Yasushi OKADA 2 , Shinji NAGATA 1 1Department of Neurosurgery,Clinical Research Institute,National Hospital Organization Kyushu Medical Center 2Cerebrovascular Disease,Clinical Research Institute,National Hospital Organization Kyushu Medical Center 3Uda Neurosurgical Clinic Keyword: carotid artery stenting , hyperperfusion syndrome , transcranial color-coded sonography , left to right ratio of mean flow velocity pp.149-154
Published Date 2011/2/10
DOI https://doi.org/10.11477/mf.1436101347
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 Hyperperfusion syndrome is a significant complication after carotid endarterectomy (CEA) or carotid artery stenting (CAS). A few reports have shown that an increase in the ratio of mean flow velocity (MFV) of the middle cerebral artery (MCA) of the affected side by transcranial color-coded sonography (TCCS) is useful for the evaluation of hyperperfusion after CEA or CAS. We report a case of hyperperfusion syndrome after CAS in which not only the increased ratio of the affected side based on preoperative mean flow velocity,but also the left to right ratio (L/R ratio) was useful for monitoring hyperperfusion. A 48-year-old man was admitted to our hospital because of cerebral infarction of the right internal carotid artery (ICA) due to stenosis of the right ICA at origin. The preoperative L/R ratio of MFV of the MCA by TCCS was 0.58. We performed CAS and the patient then developed hyperperfusion syndrome with epilepsy and was intubated under the management of strict blood control. We performed TCCS daily and the patient was extubated when the L/R ratio of MFV of the MCA decreased to 1.1 from a maximum of 2.6,although the increased ratio of MFV of the MCA of the affected side was still higher than 1.4. The patient went home without any complications from hyperperfusion. When there is preoperative laterality of cerebral blood flow,the L/R ratio of MFV by TCCS can be useful for monitoring hyperperfusion after CEA or CAS.


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電子版ISSN 1882-1251 印刷版ISSN 0301-2603 医学書院

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