Brain Complications during or after Vascular Reconstructive Surgery for Cervical Carotid Artery Stenosis(<SPECIAL ISSUE>IC Stenosis Revisited)

Abstract

Cerebral ischemic events due to generation of emboli from the surgical site and cerebral hyperperfusion syndrome are complications during or after carotid endarterectomy (CEA) or carotid artery stenting (CAS). Cerebral hyperperfusion syndrome results in postoperative cognitive impairment as well as intracerebral hemorrhage. Risk factors for development of these cerebrovascular complications include impaired cerebral hemodynamics that can be detected using brain perfusion single-photon emission computed tomography, perfusion-weighted magnetic resonance imaging or perfusion-weighted computed tomography. Considering the numbers and incidences of microemboli during procedures and intracranial hemorrhage due to hyperperfusion, patients with impaired cerebral hemodynamics should undergo CEA.