%0 Journal Article
%T Hyperventilation and breath
%A Daisuke Wajima
%A Fumihiko Nishimura
%A Hiroshi Yokota
%A Hiroyuki Nakase
%A Ichiro Nakagawa
%A Kimihiko Kichikawa
%A Shohei Yokoyama
%A Shuichi Yamada
%A Takeshi Wada
%A Yasushi Motoyama
%A Young Su Park
%J Journal of Cerebral Blood Flow & Metabolism
%@ 1559-7016
%D 2019
%R 10.1177/0271678X17743878
%X Cerebral hyperperfusion syndrome (CHS) is a serious complication following carotid artery stenting (CAS), but definitive early prediction of CHS has not been established. Here, we evaluated whether indocyanine green kinetics and near-infrared spectroscopy (ICG-NIRS) with hyperventilation (HV) and the breath-holding (BH) test can predict hyperperfusion phenomenon after CAS. The blood flow index (BFI) ratio during HV and BH was prospectively monitored using ICG-NIRS in 66 patients scheduled to undergo CAS. Preoperative cerebrovascular reactivity (CVR) and the postoperative asymmetry index (AI) were also assessed with single-photon emission computed tomography before and after CAS and the correlation with the BFI HV/rest ratio, BFI BH/rest ratio was evaluated. Twelve cases (18%) showed hyperperfusion phenomenon, and one (1.5%) showed CHS after CAS. A significant linear correlation was observed between the BFI HV/rest ratio, BFI BH/rest ratio, and preoperative CVR. A significant linear correlation was observed between the BFI HV/rest ratio and postoperative AI (r£¿=£¿0.674, P£¿<£¿0.0001). A BFI HV/rest ratio of 0.88 or more was the optimal cut-off point to predict hyperperfusion phenomenon according to receiver operating characteristic curve analyses. HV and BH test under ICG-NIRS is a useful tool for detection of hyperperfusion phenomenon in patients who underwent CAS
%K Carotid artery stenting
%K hyperperfusion syndrome
%K hyperventilation test
%K indocyanine green
%K near-infrared spectroscopy
%U https://journals.sagepub.com/doi/full/10.1177/0271678X17743878