Predictive Value of Intraoperative Transcranial Doppler Hemodynamic Monitoring for Cerebral Hyperperfusion Syndrome After Carotid Artery Stenting

ABSTRACT Background Cerebral hyperperfusion syndrome (CHS) is a potentially serious complication following carotid artery stenting (CAS). Conventional risk assessment methods may not adequately capture rapid intraoperative hemodynamic changes. Real‐time transcranial Doppler (TCD) monitoring may provide valuable information for the early identification of patients at risk of CHS. Aims To investigate the predictive value of intraoperative real‐time hemodynamic monitoring using TCD ultrasonography for CHS following CAS. Methods A total of 600 patients who underwent CAS were included. Factors associated with CHS were analyzed, and the predictive performance and clinical utility of TCD parameters measured at the T1 time point were evaluated. Results Factors associated with CHS following CAS were identified. The combined use of TCD parameters at the T1 time point demonstrated high predictive value and substantial net clinical benefit. Conclusion TCD parameters measured at the T1 time point may be useful for predicting CHS following CAS and guiding clinical decision‐making.