Hemodynamic depression during carotid angioplasty with stenting: potential risk factors determined by multidetector computed tomography angiography and related clinical factors.
OBJECTIVE
To investigate potential risk factors for hemodynamic depression (HD) in elective carotid angioplasty with stenting (CAS) by using multidetector computed tomography (MDCT) angiographic findings and clinical data.


METHODS
A retrospective study was conducted for 32 patients that underwent MDCT angiography before CAS in our hospital. We reviewed the MDCT angiographic findings to evaluate parameters including total plaque volume, composition and the composition ratio of plaque, degree of stenosis, and distance of the most stenotic portion from carotid bifurcation. Clinical data such as patient age, presence of neurological symptoms, underlying medical disease, smoking history, and previous stroke history were noted. The MDCT angiographic parameters and clinical data were then analyzed to determine a prediction for periprocedural HD (systolic blood pressure, <90 mm Hg; or heart rate, <40 beats/min).


RESULTS
Periprocedural HD was observed in 9 patients (28.1%). Among the MDCT angiographic parameters, the hemodynamic unstable group of patients had a smaller total plaque volume than that of stable group of patients (P = 0.04). The other MDCT parameters and clinical data did not show statistically significant difference between 2 groups.


CONCLUSIONS
In this study, only the total volume of plaque was a positive factor for predicting HD during CAS. Multidetector computed tomography angiography can be helpful for predicting HD during CAS.
Hwang
Kyu-Won
KW
Department of Diagnostic Radiology, Korea University College of Medicine, Seoul, Korea.
Suh
Sang-Il
SI
Seo
Woo Keun
WK
Seol
Hae-Young
HY
Kim
Ji Hyun
JH
Koh
Seong-Beom
SB
Lee
Young Hen
YH
Lee
Nam Joon
NJ
Kim
Jung Hyuk
JH
D000368:Aged; D017130:Angioplasty / Q000379:methods*; D001794:Blood Pressure; D001919:Bradycardia / Q000175:diagnosis / Q000209:etiology; D002339:Carotid Arteries / Q000000981:diagnostic imaging*; D016893:Carotid Stenosis / Q000175:diagnosis / Q000601:surgery*; D003287:Contrast Media / Q000008:administration & dosage; D017558:Elective Surgical Procedures / Q000379:methods; D005260:Female; D006339:Heart Rate; D006439:Hemodynamics; D006801:Humans; D007022:Hypotension / Q000175:diagnosis / Q000209:etiology; D007091:Image Processing, Computer-Assisted; D007472:Iohexol / Q000031:analogs & derivatives; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012307:Risk Factors; D015607:Stents; D014057:Tomography, X-Ray Computed / Q000379:methods*
D003287:Contrast Media; D007472:Iohexol; C038192:iopromide