CORRELATION BETWEEN CEREBRAL OXYGEN EXTRACTION FRACTION AND CEREBRAL HYPERPERFUSION SYNDROME AFTER CAROTID ARTERY STENTING

Abstract

Objective To investigate the relationship between changes in cerebral oxygen extraction fraction (cOEF) and the occurrence of cerebral hyperperfusion syndrome (CHS) after carotid artery stenting (CAS). Methods A total of 212 patients with carotid artery stenosis who underwent CAS from December 2015 to August 2019 were included. They were divided into normal group (175 cases) and high-perfusion group (37 cases) based on the occurrence of CHS after surgery. General information and preoperative and postoperative cOEF values were compared between the two groups. The influencing factors for CHS after CAS were analyzed using logistic regression models, and receiver operating characteristic (ROC) curves were drawn to calculate the area under the curve (AUC). Results There were significant differences in preoperative CAS degree, preoperative cOEF, and pos-toperative cOEF between the two groups (t=2.289-5.944, P <0.05). The logistic regression analysis showed that preoperative CAS degree, preoperative cOEF, and postoperative cOEF were influence factors for CHS (P <0.001). According to the ROC curves, the AUC values for the prediction of CHS by preoperative cOEF and postoperative cOEF were 0.734 (cut-off=0.442) and 0.775 (cut-off=0.521), respectively. Conclusion Preoperative cOEF >0.442 and postoperative cOEF >0.521 are risk factors for CHS after CAS, and cOEF monitoring during the perioperative period is of great clinical significance in CHS prevention.

Keywords

• carotid artery stenosis|cerebral hyperperfusion syndrome|carotid artery stenting|cerebral oxygen extraction fraction|reperfusion injury|root cause analysis