PL EN
PRACA ORYGINALNA
Risk factors and frequency of postprocedural hemodynamic instability after carotid artery stent placement
 
Więcej
Ukryj
1
Clinic of Neurology, Military Institute of Medicine; Head: prof. Adam Stępień, MD, PhD
2
Department of Interventional Radiology, Military Institute of Medicine; Head: Piotr Piasecki, MD, PhD
AUTOR DO KORESPONDENCJI
Aleksander Dębiec
adebiec@wim.mil.pl
Data publikacji: 22-09-2021
 
LW 2021;99(4):162–168
 
SŁOWA KLUCZOWE
STRESZCZENIE
The frequency, risk factors and long term consequences of reflexive postprocedural hypotension (PH) following carotid artery stenting (CAS) are not well known. Prospective analysis of 30 patients with 6-month follow-up undergoing CAS with an emboli-protection device was performed. A validated 24-hour ABPM was taken 24 hours before and after CAS. PH was defined as systolic blood pressure (SBP) <90 mm Hg, or decrease in mean arterial BP (MAP) of ≥20% or systolic BP (SBP) of ≥30 mm Hg of baseline BP reading. Neurological assessments were performed 24 hours after CAS and at 6 month follow-up visit. Median age was 69 years, 70% were male, 86% of patients had symptomatic carotid stenosis. Twenty patients (67%) experienced PH, 43% had transient bradycardia, 30% had both PH and bradycardia. The cumulated postprocedural mean SBP and DBP decreased from baseline 128/67 mm Hg to 108/54 mm Hg (p <0.01), mean day (69/min) and night HR (58/min) decreased to respectively 58/min and 49/min (p <0.01). We found no association of PH with age, ischemic heart disease, bifurcation involvement, balloon size, inflation pressure, longer lesion length. Patients with PH significantly (p <0.05) less often were treated with Ca-antagonist (25% vs 70%), more often had ipsilateral ulcerated plaque (85% vs 50%) and had hemodynamically significant stenosis of contralateral ICA (60% vs 30%). During 6 month follow-up only 1 case of neurological deterioration was noticed. PH was a common phenomenon after CAS, however it did not result in neurological complications. Patients at risk can be possibly identified through clinical and angiographic variables.
eISSN:1509-5754
ISSN:0024-0745