The Prevalence and Factors Contributing to Hemodynamic Depression in Patients Undergoing Carotid Angioplasty and Stenting.

Autor:	Borhani Haghighi A; Clinical Neurology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran ; Departments of Neurolog,y, Shiraz University of Medical Sciences, Shiraz, Iran., Kokabi S; Departments of Neurolog,y, Shiraz University of Medical Sciences, Shiraz, Iran., Yousefi S; Non communicable diseases research center, Fasa University of Medical Sciences, Fasa, Iran., Emami M; Transgenic Technology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran., Shariat A; Clinical Neurology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran ; Departments of Neurolog,y, Shiraz University of Medical Sciences, Shiraz, Iran., Nikseresht A; Clinical Neurology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran ; Departments of Neurolog,y, Shiraz University of Medical Sciences, Shiraz, Iran., Ashjazadeh N; Clinical Neurology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran ; Departments of Neurolog,y, Shiraz University of Medical Sciences, Shiraz, Iran., Izadi S; Clinical Neurology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran ; Departments of Neurolog,y, Shiraz University of Medical Sciences, Shiraz, Iran., Petramfar P; Clinical Neurology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran ; Departments of Neurolog,y, Shiraz University of Medical Sciences, Shiraz, Iran., Poursadegh M; Clinical Neurology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran ; Departments of Neurolog,y, Shiraz University of Medical Sciences, Shiraz, Iran., Jaberi AR; Clinical Neurology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran ; Departments of Neurolog,y, Shiraz University of Medical Sciences, Shiraz, Iran., Emami S; Department of Neurology, Faculty of Medicine, Jahrom University of Medical Sciences, Jahrom, Iran., Agheli H; Neurologist, Shahidzadeh Hospital, Behbahan, Iran., Nemati R; Department of Neurology, Faculty of Medicine, Bushehr University of Medical Sciences, Bushehr, Iran., Yaghoubi E; Department of Neurology, Faculty of Medicine, Yasuj University of Medical Sciences, Yasuj, Iran., Kashani K; Department of Neurology, Faculty of Medicine, Fasa University of Medical Sciences, Fasa, Iran., Panahandeh M; Neurologist, Ordibehesht Hospital, Shiraz, Iran., Heidari-Khormizi SM; Department of Neurology, Faculty of Medicine, Rafsanjan University of Medical Sciences, Rafsanjan, Iran., Cruz-Flores S; Departments of Neurology, Texas Tech University, El Paso, TX, USA., Edgell R; Departments of Neurology and Psychiatry, Saint Louis University, Saint Louis, MO, USA.
Jazyk:	angličtina
Zdroj:	Journal of vascular and interventional neurology [J Vasc Interv Neurol] 2015 Oct; Vol. 8 (4), pp. 5-10.
Abstrakt:	Background: Hemodynamic depression, including bradycardia and hypotension, is among the most common complications of carotid angioplasty and stenting. Methods and Material: A prospective, cross-sectional study was conducted at Shiraz University of Medical Sciences in southern Iran from 2011 to 2013. Consecutive patients undergoing carotid angioplasty and stenting were included. Demographic data, atherosclerotic risk factors, preprocedural blood pressure, the site of stenosis, the degree of stenosis, and data regarding technical factors were recorded. Hemodynamic depression was defined as a systolic blood pressure less than 90 mmHg and/or heart rate less than 50 beat/min. Results: About 170 patients (67% male, mean age: 71+9.8, 55.9% right side, 82.9% symptomatic) were recruited. Mean degree of stenosis was 79.4% in operated side and 40.7% in nonoperated side. Predilation, postdilation, or both were conducted in 18(10.5%), 141(83%), 11(6.5%) patients respectively. Thirteen (7.6%), 41(24%), and 12(7%) of patients developed postprocedural bradycardia, hypotension or both, respectively. Two patients had a stroke after CAS and periprocedural mortality was 0%. Hemodynamic depression after CAS had a significant association with preprocedure blood pressure and the use of an open cell stent design, but not with atherosclerotic risk factors, site and/or degree of stenosis, predilation, or postdilation. Hemodynamic depression significantly increased hospital stay too. Conclusion: Preprocedural hydration and close-cell stents may decrease the risk of poststenting hemodynamic depression.
Databáze:	MEDLINE
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