Risk factors associated with hemodynamic instability in carotid artery stenting:a systematic review and meta-analysis
10.3969/j.issn.1004-8812.2025.04.004
- VernacularTitle:颈动脉支架置入术血流动力学不稳定的相关危险因素:系统回顾和Meta分析
- Author:
La-ting ZHANG
1
;
Xiao-qing WANG
;
Lin HAN
;
Xin-hui LIANG
;
Yao JIA
;
Li-juan GAO
;
Xue JIANG
Author Information
1. 陕西中医药大学护理学院,陕西咸阳 712046;空军军医大学唐都医院神经外科,陕西西安 710038
- Publication Type:Journal Article
- Keywords:
Carotid artery stenting;
Hemodynamic instability;
Risk factors;
Meta analysis
- From:
Chinese Journal of Interventional Cardiology
2025;33(4):201-214
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the risk factors of hemodynamic instability after carotid artery stenting by meta-analysis.Methods Ten databases were searched:PubMed,ProQuest,ScienceDirect,Embase,Cochrane Library,Web of Science,China Knowledge Network,Wanfang Data,VIP Information Database,and China Biomedical Database.The search date was from inception until 2 February 2024,and meta-analysis was performed using Stata 16.0 statistical software.Results A total of 27 studies with 4199 subjects and 22 influencing factors were included.The studies showed a 37.4％(95％CI 30.3％-44.8％)incidence of haemodynamic instability after carotid stenting,Meta-analysis determined that age＞60 years(P＜0.001),hypertension(P＜0.001),calcified plaque(P＜0.001),stenosis＞70％(P=0.008),eccentric plaque(P=0.002),distance from the largest stenosis to the carotid bifurcation≤ 10 mm(P＜0.001),stenosis involvement of the balloon or bifurcation(P＜0.001),balloon post-dilation(P=0.003),open-loop stenting(P＜0.001),dilated balloon diameter≥5 mm(P=0.002),repeat balloon dilation(P=0.011)and balloon dilation pressure≥8 atm(P＜0.001)are risk factors for intraoperative and postoperative haemodynamic instability in patients undergoing carotid artery stenting surgery.Statin use was a protective factor(P＜0.001).Conclusions Medical staff working in the clinic should assess the patient's condition preoperatively,identify risk factors that may lead to haemodynamic instability,and avoid unnecessary intraoperative stimulation of patients who are already in a high-risk state.Reduce postoperative clinical complications in patients with carotid artery stenosis and improve patient recovery.
