Hyperperfusion syndrome after carotid endarterectomy

Dr Henry Knipe et al.

Hyperperfusion syndrome after carotid endarterectomy (CEA) or carotid artery stenting (CAS) is a rare complication. 

Hyperperfusion occurs in ~7.5% (range 1-14%) of patients but only a minority (~1.5%) of patients are symptomatic 2,3, with incidence being reported slightly more after CEA (~2%) than after CAS (~1%) 4

Patients present with a postoperative triad of 1,2:

Hypertension is also a common feature. Presentation is usually within the first week of surgery but has been reported up to a month after surgery 2

The pathophysiological mechanism is unknown but thought to be secondary to increased cerebral blood flow (CBF) from a loss of cerebral autoregulation 2,3. Hyperperfusion is defined as CBF >100% above preoperative baseline but patients have been reported to be symptomatic with increases of 20-40% 2

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Article Information

rID: 48821
Section: Syndromes
Tag: cases
Synonyms or Alternate Spellings:
  • Hyperperfusion syndrome after carotid artery stenting
  • Cerebral hyperperfusion syndrome after carotid intervention
  • Reperfusion syndrome after carotid endarterectomy

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