Quantification Of Superoxide Dismutase And IFLOW On CAS:A Preliminary Study On The Prediction Of Hyperperfusion Syndrome

Object:Preliminary study of the feasibility of using iFLOW technique and superoxide dismutase(SOD)to assess high perfusion syndrome(CHS)after carotid artery stenting(CAS)Materials and methods:We analysis 30 patients due to unilateral carotid artery severe stenosis(stenosis?70%)of carotid artery stent.The serum was taken from the elbow vein at different time which were 3 hours before the CAS and 72 hours after the CAS.The levels of superoxide dismutase(SOD)were measured by enzyme-linked immunosorbent assay(ELISA)and were compared within groups and between the two groups.IFLOW technique was performed immediately before and after surgery: 1)Three ROIs were selected in the iFlow image: the initial part of the internal carotid artery and bifurcation of the middle cerebral artery.2)Determine the TTP of each region of interest to calculate the difference between the onset of the internal carotid artery and the end of the carotid artery TTP.3)Calculate the difference in TTP between the origin of the internal carotid artery and bifurcation of the middle cerebral artery.Thirty patients were divided into cerebral hyperperfusion syndrome group and no hyperperfusion syndrome group(control group)according to postoperative clinical symptoms and cerebral hyperperfusion syndrome(CHS)score.Whether it is significant difference between the group and the control group and the general clinical data of the hyperperfusion syndrome group and the control group.For the count data,we use chi-square test and we use t test when it is measurement data.The t test of independent samples was used to compare the data between the different groups.The t-test of the matched samples was analyzed by t test.P <0.05 that the difference was statistically significant.Results: 30 patients were successfully performed carotid artery stenting,a total of 33 stents were implanted,of which,one patients was implanted with 2 stent,another was 3 stent.1.There was no significant difference in age,sex,hypertension,diabetes mellitus,type and quantity of stent implantation(P > 0.05).But there was significant difference in degree of carotid stenosis(P<0.05).2.There was significant difference between the two groups(P <0.05).Compared with the control group,the serum SOD value of the hyperperfusion group was significantly lower than that of the control group(P<0.05).3.Preoperative and postoperative TTP in group iFLOW and the group had no statistical significance(P > 0.05).Showing that there was no significant difference between the two groups before and after TTP.Conclusion:1.Because of unilateral carotid artery stenosis in patients with carotid artery stent implantation,the preoperative and postoperative of SOD value changes indirectly reflect the concentration of oxygen free radicals,which is expected to predict the perfusion syndrome.2.The difference in TTP in iFLOW did not predict hyperperfusion syndrome.3.The degree of stenosis of the target vessels may be associated with the occurrence of CHS.The more severe the degree of stenosis,the greater the possibility of the occurrence of the syndrome.