Risk factors for cerebral hyperperfusion syndrome after carotid revascularization: A meta-analysis involving 158,624 participants

Introduction This study aimed to delineate the risk factors associated with cerebral hyperperfusion syndrome (CHS) following carotid revascularization. Material and methods Comprehensive searches of the relevant medical database yielded potentially eligible studies . We conducted a meta-analysis using RevMan 5.3. Results Results demonstrated that diabetes (OR = 3.16, 95% CI (1.26, 7.93), P = 0.01), coronary artery disease (OR = 1.69, 95% CI (1.04, 2.74), P = 0.03), a history of stroke (OR = 2.51, 95% CI (1.75, 3.59), P < 0.00001), degree of stenosis (OR = 1.08, 95% CI (1.02, 1.14), P = 0.008), and an operation time window of less than two weeks (OR = 3.78, 95% CI (1.83, 7.82), P = 0.0003) constituted risk factors for CHS following carotid revascularization. Conversely, robust collateral circulation served as a protective factor (OR = 0.20, 95% CI (0.10, 0.42), P < 0.0001). Other factors such as male gender (OR = 1.02, 95% CI (0.63, 1.65), P = 0.93), hypertension (OR = 1.23, 95% CI (0.77, 1.96), P = 0.39), hyperlipidemia (OR = 1.18, 95% CI (0.70, 2.00), P = 0.54), prior alcohol consumption (OR = 0.99, 95% CI (0.62, 1.60), P = 0.98), smoking history (OR = 0.82, 95% CI (0.41, 1.64), P = 0.58), intraoperative hypertension (OR = 1.73, 95% CI (0.77, 3.88), P = 0.18), and postoperative hypertension (OR = 2.81, 95% CI (0.32, 24.33), P = 0.35) showed no significant association with CHS post-revascularization. Conclusions This investigation elucidated the risk and protective factors for CHS after carotid artery revascularization.