Prediction of Prolonged Hemodynamic Instability During Carotid Angioplasty and Stenting.
10.5469/neuroint.2016.11.2.120
- Author:
Jong Kook RHIM
1
;
Jin Pyeong JEON
;
Jeong Jin PARK
;
Hyuk Jai CHOI
;
Young Dae CHO
;
Seung Hun SHEEN
;
Kyung Sool JANG
Author Information
1. Department of Neurosurgery, Jeju National University College of Medicine, Jeju, Korea.
- Publication Type:Original Article
- Keywords:
Carotid angioplasty and stenting;
Hemodynamic instability;
Stent
- MeSH:
Angioplasty*;
Blood Pressure;
Cohort Studies;
Constriction, Pathologic;
Heart Rate;
Hemodynamics*;
Humans;
Risk Factors;
Stents*
- From:Neurointervention
2016;11(2):120-126
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: The aim of this study was to assess the risk factors of prolonged hemodynamic instability (HDI) after carotid angioplasty and stenting (CAS). Herein, a simplified predictive scoring system for prolonged HDI is proposed. MATERIALS AND METHODS: Sixty-six patients who had CAS from 2011 to 2016 at a single institution were evaluated. Prolonged HDI was defined as systolic blood pressure >160 mm Hg or <90 mm Hg or heart rate <50 beats/min, lasting over 30 minutes despite medical treatments. For the study, clinical data and radiologic data, including plaque morphology and stenosis were analyzed. RESULTS: Prolonged HDI was observed in 21 patients (31.8%). Multivariable analysis revealed that calcification (OR, 6.726; p=0.006), eccentric stenosis (OR, 3.645; p=0.047) and extensive plaque distribution (OR, 7.169; p=0.006) were related to prolonged HDI. According to these results, a simplified scoring scale was proposed based on the summation of points: 2 points for calcified plaque, 2 points for extensive plaque distribution, and 1 point for eccentric stenosis. The percentages of prolonged HDI according to the total score were as follows: score 0, 8.7%; score 1, 20.0%; score 2, 38.5%; score 3, 72.7%; score 4, 66.7%; score 5, 100%. From the analysis, the total score in patients with prolonged HDI was significantly higher than those without prolonged HDI (p<0.001). CONCLUSION: Prolonged HDI can be associated with calcification of plaque, eccentric stenosis and extensive plaque distribution, and a simplified scoring system enables prediction of prolonged HDI according to our cohort.
