Cerebral hyperperfusion syndrome after endovascular covered stent grafting for a giant extracranial aneurysm of the internal carotid artery

Sakyo Hirai; Kuniyasu Saigusa; Yasuhiro Norisue; Shigeru Nemoto

doi:10.1016/j.jvsc.2014.11.004

Cerebral hyperperfusion syndrome after endovascular covered stent grafting for a giant extracranial aneurysm of the internal carotid artery

J Vasc Surg Cases. 2015 Mar 17;1(1):46-49. doi: 10.1016/j.jvsc.2014.11.004. eCollection 2015 Mar.

Authors

Sakyo Hirai¹, Kuniyasu Saigusa¹, Yasuhiro Norisue², Shigeru Nemoto³

Affiliations

¹ Department of Neurosurgery, Tokyo Bay Urayasu Ichikawa Medical Center, Chiba, Japan.
² Department of Intensive Care Medicine, Tokyo Bay Urayasu Ichikawa Medical Center, Chiba, Japan.
³ Department of Endovascular Surgery, Tokyo Medical and Dental University, University Hospital of Medicine, Tokyo, Japan.

Abstract

Symptomatic giant extracranial internal carotid artery (ICA) aneurysm is a rare and surgically intractable disease. Several authors have described successful treatments for extracranial ICA aneurysm. None, however, have described a perioperative evaluation of cerebral perfusion or a postoperative complication of cerebral hyperperfusion syndrome (CHS). We present a rare case of CHS after endovascular covered stent grafting for a giant extracranial ICA aneurysm. The CHS was successfully managed on the basis of hemodynamic monitoring. CHS can appear after endovascular reconstruction of an extracranial ICA aneurysm, and perioperative repeated evaluation of cerebral perfusion allows safe and effective management of CHS.