Hemodynamic Instability during Carotid Angioplasty and Stenting-Relationship of Calcified Plaque and Its Characteristics.
10.3349/ymj.2013.54.2.295
- Author:
Jin Sue JEON
1
;
Seung Hun SHEEN
;
Gyojun HWANG
Author Information
1. Department of Neurosurgery, Hallym University College of Medicine, Chuncheon Sacred Heart Hospital, Chuncheon, Korea. neurosheen@gmail.com
- Publication Type:Original Article
- Keywords:
Carotid angioplasty and stenting;
hemodynamic instability;
bradycardia;
hypotension
- MeSH:
Aged;
Angioplasty/*adverse effects;
Bradycardia/complications;
Carotid Arteries/*surgery;
Carotid Stenosis/*physiopathology;
Female;
*Hemodynamics;
Humans;
Hypotension/complications;
Intraoperative Complications/*etiology/radiography;
Intraoperative Period;
Logistic Models;
Male;
Middle Aged;
Retrospective Studies;
Risk Factors;
Stents;
Tomography, X-Ray Computed
- From:Yonsei Medical Journal
2013;54(2):295-300
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: During carotid angioplasty and stenting (CAS), hemodynamic instability (HDI) can occur, possibly causing post-procedural ischemic complications. The goal of this study was to investigate the risk factors of HDI focusing on characteristics of plaque. MATERIALS AND METHODS: Thirty nine CAS patients were retrospectively evaluated for HDI. Prolonged HDI that lasted over 30 minutes was analyzed in relation to characteristics of calcified plaque. RESULTS: Nineteen (48.7%) patients had HDI. Ten of the 19 had both bradycardia and hypotension, and nine had only bradycardia. All bradycardia was treated well with a transcutaneous temporary cardiac pacemaker. But eight patients presented with prolonged hypotension in spite of recovery of bradycardia. Calcified plaque was a related factor associated with HDI (odds ratio, 8.571; 95% confidence interval, 1.321-55.62; p=0.024). Extensive and eccentric type calcified plaques were associated with prolonged hypotension (p=0.04, and p=0.028, respectively). CONCLUSION: The calcification of plaque is a predictable factor of HDI during CAS, and its extensive and eccentric calcified plaques may be related to prolonged HDI.
