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Haghighi AB, Kokabi S, Yousefi S, Emami M, Shariat A, Nikseresht A, Ashjazadeh N, Izadi S, Petramfar P, Poursadegh M, Jaberi AR, Emami S, Agheli H, Nemati R, Yaghoubi E, Kashani K, Panahandeh M, Heidari-Khormizi SM, Cruz-Flores S, Edgell R. The Prevalence and Factors Contributing to Hemodynamic Depression in Patients Undergoing Carotid Angioplasty and Stenting. J Vasc Interv Neurol 2015; 8:5-10. [PMID: 26600923 PMCID: PMC4634774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
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.
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Affiliation(s)
- Afshin Borhani Haghighi
- Clinical Neurology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
- Departments of Neurolog,y, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Safoora Kokabi
- Departments of Neurolog,y, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Samaneh Yousefi
- Non communicable diseases research center, Fasa University of Medical Sciences, Fasa, Iran
| | - Mehrdad Emami
- Transgenic Technology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Abdolhamid Shariat
- Clinical Neurology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
- Departments of Neurolog,y, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Alireza Nikseresht
- Clinical Neurology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
- Departments of Neurolog,y, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Nahid Ashjazadeh
- Clinical Neurology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
- Departments of Neurolog,y, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Sadegh Izadi
- Clinical Neurology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
- Departments of Neurolog,y, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Peyman Petramfar
- Clinical Neurology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
- Departments of Neurolog,y, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Maryam Poursadegh
- Clinical Neurology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
- Departments of Neurolog,y, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Abbas Rahimi Jaberi
- Clinical Neurology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
- Departments of Neurolog,y, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Sajjad Emami
- Department of Neurology, Faculty of Medicine, Jahrom University of Medical Sciences, Jahrom, Iran
| | - Hamid Agheli
- Neurologist, Shahidzadeh Hospital, Behbahan, Iran
| | - Reza Nemati
- Department of Neurology, Faculty of Medicine, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Ehsan Yaghoubi
- Department of Neurology, Faculty of Medicine, Yasuj University of Medical Sciences, Yasuj, Iran
| | - Kaveh Kashani
- Department of Neurology, Faculty of Medicine, Fasa University of Medical Sciences, Fasa, Iran
| | | | | | | | - Randal Edgell
- Departments of Neurology and Psychiatry, Saint Louis University, Saint Louis, MO, USA
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