Ipsilateral hypoperfusion caused by intracerebral steal phenomenon after carotid artery stenting: a case report
Abstract Background Abnormal hypoperfusion on the surgical side after carotid artery stenting is rare. Neurological deterioration caused by it is deceptive, which can easily lead to misdiagnosis. The mechanism of hypoperfusion has rarely been demonstrated. We present here a fully studied case with a...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2021-05-01
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| Series: | BMC Neurology |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12883-021-02208-6 |
| _version_ | 1818675359816613888 |
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| author | Zhizhong Yan Zhonghua Shi Yuhai Wang Chunlei Zhang Huize Liu Jin Cai Xin Zhang |
| author_facet | Zhizhong Yan Zhonghua Shi Yuhai Wang Chunlei Zhang Huize Liu Jin Cai Xin Zhang |
| author_sort | Zhizhong Yan |
| collection | DOAJ |
| description | Abstract Background Abnormal hypoperfusion on the surgical side after carotid artery stenting is rare. Neurological deterioration caused by it is deceptive, which can easily lead to misdiagnosis. The mechanism of hypoperfusion has rarely been demonstrated. We present here a fully studied case with a high probability of intracerebral steal phenomenon. Case presentation A 68-year-old male with severe right internal carotid artery stenosis and left internal carotid artery occlusion underwent right stenosis stent implantation. Restlessness and left limb hemiplegia occurred within 24 h after the procedure, which was similar to hyperperfusion syndrome. However, postoperative computerized tomography perfusion (CTP) revealed abnormal hypoperfusion in the right hemisphere. Transcranial Doppler (TCD) also showed decreased flow velocity in the right middle cerebral artery, and increased flow velocity in the right anterior cerebral artery. We considered that intracerebral steal phenomenon might be the cause, then hypervolemic therapy was accepted and the symptoms completely resolved after 3 days. Conclusions Ipsilateral hypoperfusion is rarely seen after carotid artery stenting. Intracerebral steal phenomenon may be the underlying mechanism. CTP or TCD is helpful for the early detection of this adverse event. |
| first_indexed | 2024-12-17T08:26:20Z |
| format | Article |
| id | doaj.art-4474e4181c764e75afddb4a405a67693 |
| institution | Directory Open Access Journal |
| issn | 1471-2377 |
| language | English |
| last_indexed | 2024-12-17T08:26:20Z |
| publishDate | 2021-05-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Neurology |
| spelling | doaj.art-4474e4181c764e75afddb4a405a676932022-12-21T21:56:46ZengBMCBMC Neurology1471-23772021-05-012111410.1186/s12883-021-02208-6Ipsilateral hypoperfusion caused by intracerebral steal phenomenon after carotid artery stenting: a case reportZhizhong Yan0Zhonghua Shi1Yuhai Wang2Chunlei Zhang3Huize Liu4Jin Cai5Xin Zhang6Department of Neurosurgery, The 904 th Hospital of the Joint Logistics Support force of Chinese People’s Liberation ArmyDepartment of Neurosurgery, The 904 th Hospital of the Joint Logistics Support force of Chinese People’s Liberation ArmyDepartment of Neurosurgery, The 904 th Hospital of the Joint Logistics Support force of Chinese People’s Liberation ArmyDepartment of Neurosurgery, The 904 th Hospital of the Joint Logistics Support force of Chinese People’s Liberation ArmyDepartment of Neurosurgery, The 904 th Hospital of the Joint Logistics Support force of Chinese People’s Liberation ArmyDepartment of Neurosurgery, Jinling Hospital, The First School of Clinical Medicine, Southern Medical UniversityDepartment of Neurosurgery, Jinling Hospital, The First School of Clinical Medicine, Southern Medical UniversityAbstract Background Abnormal hypoperfusion on the surgical side after carotid artery stenting is rare. Neurological deterioration caused by it is deceptive, which can easily lead to misdiagnosis. The mechanism of hypoperfusion has rarely been demonstrated. We present here a fully studied case with a high probability of intracerebral steal phenomenon. Case presentation A 68-year-old male with severe right internal carotid artery stenosis and left internal carotid artery occlusion underwent right stenosis stent implantation. Restlessness and left limb hemiplegia occurred within 24 h after the procedure, which was similar to hyperperfusion syndrome. However, postoperative computerized tomography perfusion (CTP) revealed abnormal hypoperfusion in the right hemisphere. Transcranial Doppler (TCD) also showed decreased flow velocity in the right middle cerebral artery, and increased flow velocity in the right anterior cerebral artery. We considered that intracerebral steal phenomenon might be the cause, then hypervolemic therapy was accepted and the symptoms completely resolved after 3 days. Conclusions Ipsilateral hypoperfusion is rarely seen after carotid artery stenting. Intracerebral steal phenomenon may be the underlying mechanism. CTP or TCD is helpful for the early detection of this adverse event.https://doi.org/10.1186/s12883-021-02208-6Intracerebral steal phenomenonStentingEndovascular treatmentCarotid artery |
| spellingShingle | Zhizhong Yan Zhonghua Shi Yuhai Wang Chunlei Zhang Huize Liu Jin Cai Xin Zhang Ipsilateral hypoperfusion caused by intracerebral steal phenomenon after carotid artery stenting: a case report BMC Neurology Intracerebral steal phenomenon Stenting Endovascular treatment Carotid artery |
| title | Ipsilateral hypoperfusion caused by intracerebral steal phenomenon after carotid artery stenting: a case report |
| title_full | Ipsilateral hypoperfusion caused by intracerebral steal phenomenon after carotid artery stenting: a case report |
| title_fullStr | Ipsilateral hypoperfusion caused by intracerebral steal phenomenon after carotid artery stenting: a case report |
| title_full_unstemmed | Ipsilateral hypoperfusion caused by intracerebral steal phenomenon after carotid artery stenting: a case report |
| title_short | Ipsilateral hypoperfusion caused by intracerebral steal phenomenon after carotid artery stenting: a case report |
| title_sort | ipsilateral hypoperfusion caused by intracerebral steal phenomenon after carotid artery stenting a case report |
| topic | Intracerebral steal phenomenon Stenting Endovascular treatment Carotid artery |
| url | https://doi.org/10.1186/s12883-021-02208-6 |
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