Hyperperfusion and intracranial haemorrhage after carotid angioplasty with stenting - latest review

The number of endovascular procedures is constantly increasing. As far as the carotid artery is concerned, carotid angioplasty with stenting (CAS) is an alternative to surgical treatment (carotid endarterectomy; CEA). Two major devastating complications can occur after both procedures - cerebral hyperperfusion syndrome (CHS) and intracranial haemorrhage (ICH). The incidence of CHS and ICH in CAS is fortunately low but overall morbidity and mortality remains high. This latest review re-evaluates the pathogenesis, clinical features, risk factors and diagnostic procedures as well as management of these two complications.