By T. Forbes
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Extra info for Angioplasty - Var. Techniques, Challs. in Trtmt. of Congen., Acq., Vasc. Stenoses
The postprocedural BP in the CHS cohort tended to be higher than in the other patients, but this difference did not reach statistical significance. Modifiable Potential risk factors for CHS Not modifiable High blood pressure Excessive administration of antithrombotic drugs Simultaneous revascularization of multiple vessels Use of high doses of volatile halogenated hydrocarbon anesthetics Recent (<3 months) contralateral CEA Diminished CVR Hypertensive microangiopathy Recent minor stroke Age >70 years High grade carotid artery stenosis Incomplete circle of Willis Contralateral carotid occlusion Poor collateral flow Increase in regional cerebral oxygen saturation >24% Diabetes mellitus, Hypertension Increase in perfusion >100% Preoperative hypoperfusion Table 2.
Timing of carotid surgery after acute stroke. Expert Rev Cardiovasc Ther 2010 vol. 8 (10) pp. ; Edelenbosch, R & Muskens, E et al. An observational study of preoperative transcranial Doppler examinations to predict cerebral hyperperfusion following carotid endarterectomies. Neurol Res 2001; 23: 593-8. ; Menon, DK & Pickard, JD. Near-infrared spectroscopy use in patients with head injury. J Neurosurg 1995; 83: 963–970. ; Gupta, D & Smith, WS, et al. Cerebral blood flow changes after endovascular treatment of cerebro- vascular stenoses.
Regarding strict control of BP, Abou-Chebl et al (2007) published an interesting study that analyzed the presence of CHS and ICH in 836 patients treated with CAS. , risk factors for CHS). They conclude that comprehensive management of arterial hypertension can lower the incidence of ICH and CHS in high-risk patients following CAS, without additional complications or prolonged hospitalization. The strict control of BP must be maintained until CVR is restored, and this interval varies among patients.
Angioplasty - Var. Techniques, Challs. in Trtmt. of Congen., Acq., Vasc. Stenoses by T. Forbes