Carotid artery calcification score is associated with the occurrence of cerebral hyperperfusion syndrome after carotid artery stenting

OBJECTIVE: The objective is to explore the correlation between carotid artery calcification score and cerebral hyperperfusion syndrome (CHS) after carotid artery stenting (CAS) in patients with carotid artery stenosis. METHODS: Consecutive patients treated for carotid artery stenosis from October 2016 to August 2021 from two centers were studied. Carotid artery calcification score was manually segmented on multi-detector row spiral computed tomography angiography scans before CAS. The associations between carotid artery calcification score and the occurrence of CHS during the in-hospital time were assessed. RESULTS: A total of 175 patients were enrolled in the study. The mean age was 72.12 ± 7.51 years. All patients were undergone CAS treatment successfully. There were 46 cases that occurred CHS (26.29%). Univariate logistic regression analyses showed that for every 1 unit (100-score) increase in carotid artery calcification score, the risk of CHS increased by 1937% (odds ratio [OR] = 20.37, 95% confidence interval [CI]: 7.54–55.03, P < 0.01). In addition, the increasing rate was significantly different between the open-cell group (OR = 261.7, P < 0.01) and the closed-cell group (OR = 11.4, P < 0.01). The area under curve of predictiong model of carotid artery calcification score to CHS was 0.84 (95% CI, 0.75–0.93). CONCLUSION: Carotid artery calcification score was an independent risk factor for CHS in patients who underwent CAS. The application of carotid artery calcification score as risk factor in clinical screening of carotid artery stenosis patients may have beneficial effects on the management of CAS.