Hyperperfusion syndrome after carotid revascularization

J Vasc Surg. 2009 Apr;49(4):1060-8. doi: 10.1016/j.jvs.2008.11.026. Epub 2009 Feb 26.


Cerebral hyperperfusion syndrome is a rare, serious complication of carotid revascularization either after carotid endarterectomy or carotid stent placement. Impaired cerebral autoregulation and post-revascularization changes in cerebral hemodynamics are the main mechanisms involved in the development of the syndrome. Hyperperfusion syndrome may be fatal once an intracranial hemorrhage occurs. This article reviews the literature, intending to make a synthesis of all new data concerning the clinical manifestations of hyperperfusion syndrome, the pathophysiologic pathways involved in its development, the prediction, and the appropriate management. Also, a review of the most recent series of hyperperfusion syndrome following carotid revascularization, both with classic open endarterectomy and carotid artery stenting has been performed.

Publication types

  • Review

MeSH terms

  • Angioplasty / adverse effects*
  • Angioplasty / instrumentation
  • Blood Pressure
  • Carotid Artery Diseases / surgery*
  • Cerebrovascular Circulation*
  • Cerebrovascular Disorders / diagnosis
  • Cerebrovascular Disorders / etiology*
  • Cerebrovascular Disorders / physiopathology
  • Cerebrovascular Disorders / therapy
  • Endarterectomy, Carotid / adverse effects*
  • Homeostasis
  • Humans
  • Intracranial Hemorrhages / diagnosis
  • Intracranial Hemorrhages / etiology*
  • Intracranial Hemorrhages / physiopathology
  • Intracranial Hemorrhages / therapy
  • Risk Factors
  • Stents
  • Syndrome
  • Terminology as Topic
  • Treatment Outcome