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Intracerebral hemorrhage as a manifestation of cerebral hyperperfusion syndrome after carotid revascularization: systematic review and meta-analysis

2017-11Journal article Restricted
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dc.contributor.authorAbreu, Pedro
dc.contributor.authorNogueira, Jerina
dc.contributor.authorRodrigues, Filipe Brogueira
dc.contributor.authorNascimento, Ana
dc.contributor.authorCarvalho, Mariana
dc.contributor.authorMarreiros, Ana
dc.contributor.authorNzwalo, Hipólito
dc.date.accessioned2019-11-20T15:07:14Z
dc.date.available2019-11-20T15:07:14Z
dc.date.issued2017-11
dc.description.abstractIntracerebral hemorrhage (ICH) in the context of cerebral hyperperfusion syndrome (CHS) is an uncommon but potentially lethal complication after carotid revascularization for carotid occlusive disease. Information about its incidence, risk factors and fatality is scarce. Therefore, we aimed to perform a systematic review and meta-analysis focusing on the incidence, risk factors and outcomes of ICH in the context of CHS after carotid revascularization. We searched the PubMed and EBSCO hosts for all studies published in English about CHS in the context of carotid revascularization. Two reviewers independently assessed each study for eligibility based on predefined criteria. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed, and the PROSPERO register was made (register no. CRD42016033190), including the pre-specified protocol. Forty-one studies involving 28,956 participants were deemed eligible and included in our analysis. The overall quality of the included studies was fair. The pooled frequency of ICH in the context of CHS was 38% (95% CI: 26% to 51%, I2 = 84%, 24 studies), and the pooled case fatality of ICH after CHS was 51% (95% CI: 32% to 71%, I2 = 77%, 17 studies). When comparing carotid angioplasty with stenting (CAS) with carotid endarterectomy (CEA), post-procedural ICH in the context of CHS was less frequent in CEA. ICH following CHS occurred less often in large series and was rare in asymptomatic patients. The most common risk factors were periprocedural hypertension and ipsilateral severe stenosis. ICH as a manifestation of CHS is rare, more frequent after CAS and associated with poor prognosis. Periprocedural control of hypertension can reduce its occurrence.
dc.identifier.doi10.1007/s00701-017-3328-4
dc.identifier.issn0001-6268
dc.identifier.issn0942-0940
dc.identifier.urihttp://hdl.handle.net/10400.1/12938
dc.language.isoeng
dc.peerreviewedyes
dc.publisherSpringer Wien
dc.subjectTranscranial doppler
dc.subjectIntracranial hemorrhage
dc.subjectIdentify patients
dc.subjectEndarterectomy
dc.subjectAngioplasty
dc.subjectStroke
dc.subjectRisk
dc.subjectSeries
dc.titleIntracerebral hemorrhage as a manifestation of cerebral hyperperfusion syndrome after carotid revascularization: systematic review and meta-analysis
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage2097
oaire.citation.issue11
oaire.citation.startPage2089
oaire.citation.titleActa Neurochirurgica
oaire.citation.volume159
person.familyNameNogueira
person.familyNameMarreiros
person.familyNameNzwalo
person.givenNameJerina
person.givenNameAna
person.givenNameHipólito
person.identifier337064
person.identifier.ciencia-id9A12-9450-7051
person.identifier.ciencia-id2C1F-E4F3-2C79
person.identifier.orcid0000-0001-9349-7594
person.identifier.orcid0000-0001-9410-4772
person.identifier.orcid0000-0002-1502-3534
person.identifier.ridAAG-3931-2020
person.identifier.scopus-author-id57194785077
person.identifier.scopus-author-id36057285600
rcaap.rightsrestrictedAccess
rcaap.typearticle
relation.isAuthorOfPublication54981fd1-18b8-445d-af14-b3e38d5792b4
relation.isAuthorOfPublicationc0a8e5da-26ae-42a8-ab04-fa4df4356375
relation.isAuthorOfPublication287f7d4e-5ad8-4794-b526-c61d32c00446
relation.isAuthorOfPublication.latestForDiscovery54981fd1-18b8-445d-af14-b3e38d5792b4

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