Clinical Characteristics And Related Factors Of Cerebral Hyperperfusion Cerebral Intracranial Hemorrhage After Carotid Artery Stenting

Objective: To analyze the clinical features of Cerebral Hyperperfusion Intracranial Hemorrhage(HICH)after Carotid Artery Stent(CAS)and explore the related factors of HICH.Methods: The clinical data of 282 patients with CAS were collected from the first affiliated hospital of Guangxi Medical University from August 2012 to December 2017.The clinical features of 7 patients with HICH were collected and divided into hyperperfusion intracranial hemorrhage groups(n=7)and no hyperperfusion intracranial hemorrhage group(n=275),retrospective analysis of the clinical data of the two groups.Results: 282 patients with carotid stenosis were successfully completed CAS,postoperative HICH 7 cases,the incidence of the disease was 2.48%,were male,the average age was(62.57±8.50)years old,2 patients underwent bilateral CAS,5 patients underwent unilateral CAS Among them,5 cases of lobar hemorrhage,2 cases of lobar hemorrhage and subarachnoid hemorrhage;postoperative hemorrhage mean time was 17.57h;clinical manifestations of headache,disturbance of consciousness,focal neurological dysfunction,abnormal behavior,etc.;5 cases Postoperative blood pressure control was poor.One patient had postoperative systolic blood pressure as high as 202 mmHg.Seven patients had different degrees of stenosis after arterial revascularization.Three patients also underwent posterior circulatory artery stenting;three patients had internal and external cervical internal and external necks on both sides.The arteries,anterior and posterior communicating arteries,and meningeal branches were not compensated;2 patients with cerebral hemorrhage died and 5 patients with cerebral hemorrhage were improved and discharged.Through univariate analysis,two groups of age,gender,history of cerebral infarction at 3 months,history of coronary heart disease,history of TIA,history of diabetes,history of smoking,history of alcohol consumption,whether or not symptomatic stenosis,postoperative circulatory artery stent placement,and surgery side Carotid stenosis,contralateral carotid artery stenosis,anterior and posterior communicating artery opening,development of anterior cerebral artery,middle cerebral arterial stenosis,and contralateral middle cerebral artery stenosis were not statistically significant(P>0.05).Compared with the HICH-free group,there was a significant difference in postoperative blood pressure(P=0.001,P<0.05)and posterior circulation arterial stenosis(P=0.023,P<0.05)in the HICH group.Whether bleeding was used as a dependent variable,posterior circulation stenosis,postoperative hypertension,age,gender,diabetes,hypertension,symptomatic carotid artery stenosis,and symptomatic carotid artery stenosis as a covariate to construct a two-class model showed postoperative blood pressure rise There was a statistically significant difference in high(OR=14.952,95% CI:2.543-87.906,P=0.03).Conclusion: Cerebral hyperperfusion intracranial hemorrhage after stenting is associated with increased blood pressure after surgery and posteriorcirculation arterial stenosis.The remaining relevant factors need to be further confirmed by the study of the sample size.