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Objective: Cerebral hyperperfusion syndrome (CHS) following carotid artery stenting (CAS) or carotid endarterectomy (CEA) is rare but often fatal once intracranial hemorrhage has occurred. In particular, CHS occurs significantly earlier after CAS than after CEA. Thus a monitoring method for early detection of CHS is required. Near-infrared spectroscopy (NIRS) provides a noninvasive monitoring technique for assessing regional cerebral oxygen saturation (rSO₂). This study evaluated the usefulness of transcranial NIRS during CAS for prediction of CHS.

Methods: Periprocedural rSO₂ was monitored in 64 cases of CAS (52 men, 12 women; 71 ± 6.6 years). The average degree of carotid stenosis was 76.8 ± 11.3% by North American Symptomatic Carotid Endarterectomy Trial criteria. Bifrontal rSO₂ was monitored during the procedure using NIRS. Seventeen patients were symptomatic and 47 were asymptomatic …