title: Ballooning-induced bradycardia during carotid stenting in primary stenosis and restenosis.
abstract: BACKGROUND
  We compared the incidence of intraprocedural bradycardia and hypotension during carotid artery stenting in patients with primary carotid artery stenosis and those with prior ipsilateral carotid endarterectomy.
  
  
  METHODS
  A total of 213 carotid stenting procedures were performed in our institution in a 4-year period. The mean degree of stenosis was 78% (range 60-99%). Of these 213 procedures, 43 were performed for carotid restenosis, 9 after stenting and 34 after endarterectomy, and 170 for primary stenosis. Atropine was selectively administrated if patients suffered bradycardia (a decrease in heart rate to <50% or an absolute heart rate of <40 bpm) or hypotension (systolic blood pressure <90 mmHg). We compared the group of patients with primary stenosis (n=170) and the group of patients with restenosis after carotid endarterectomy (n=34) in relation to intraprocedural hypotension or bradycardia/need for atropine administration.
  
  
  RESULTS
  Hypotension occurred in 49 patients with primary stenosis and 2 patients with restenosis. The difference was statistically significant. Atropine was administered for bradycardia to 58 patients with primary stenosis and 3 patients with restenosis. The difference was statistically significant.
  
  
  CONCLUSIONS
  Intraprocedural bradycardia and hypotension occur more frequently in patients with primary carotid artery stenosis.
authors: 1st Unit of Vascular Surgery, Istituto Policlinico San Donato, University of Milan, Milan, Italy.
authors: Giovanni
authors: G
authors: Nano
authors: Ilias
authors: I
authors: Dalainas
authors: Paolo
authors: P
authors: Bianchi
authors: Silvia
authors: S
authors: Stegher
authors: Luciano
authors: L
authors: Bet
authors: Giovanni
authors: G
authors: Malacrida
authors: Domenico G
authors: DG
authors: Tealdi