Published online Feb 28, 2015. doi: 10.4329/wjr.v7.i2.45
Peer-review started: October 29, 2014
First decision: December 12, 2014
Revised: December 25, 2014
Accepted: January 15, 2015
Article in press: January 19, 2015
Published online: February 28, 2015
AIM: To evaluate the changes of intracranial blood flow after carotid artery stenting (CAS), using the flow assessment application “Flow-Insight”, which was developed in our department.
METHODS: Twenty patients treated by CAS participated in this study. We analyzed the change in concentration of the contrast media at the anterior-posterior and profile view image with the flow assessment application “Flow-Insight”. And we compared the results with N-isopropyl-p-[123I] iodoamphetamine-single-photon emission computed tomography (IMP SPECT) performed before and after the treatment.
RESULTS: From this study, 200% of the parameter “blood flow” change in the post/pre-treatment is suggested as the critical line of the hyperperfusion syndrome arise. Although the observed blood flow increase in the digital subtraction angiography system did not strongly correlate with the rate of increase of SPECT, the “Flow-Insight” reflected the rate of change of the vessels well. However, for patients with reduced reserve blood flow before CAS, a highly elevated site was in agreement with the site analysis results.
CONCLUSION: We concluded that the cerebral angiography flow assessment application was able to more finely reveal hyperperfusion regions in the brain after CAS compared to SPECT.
Core tip: Hyperperfusion syndrome is a relatively rare, but potentially serious, complication of carotid revascularization procedures. It is important to detect the excessive increase blood flow after treatment as soon as possible. We found that, although the observed blood flow increase in the digital subtraction angiography system did not strongly correlate with the rate of increase of single-photon emission computed tomography before and after carotid artery stenting, the digital subtraction angiography flow assessment application more finely reflected the rate of change of the vessels well.