title: Dexmedetomidine as sole sedative during percutaneous carotid artery stenting in a patient with severe chronic obstructive pulmonary disease.
abstract: Carotid artery ballooning and stenting is a percutaneous interventional therapy for the treatment of patients with atherosclerotic occlusive disease of the carotid artery. Patients with severe comorbidities are usually considered candidates for this procedure. The carotid artery stenting can be done under either general or strict local anesthesia, or alternatively by using a combination of intravenous sedation and local anesthesia. Dexmedetomidine is a selective alpha-adrenergic agent that has both sedative and analgesic properties but lacks a depressive effect on respiratory drive. This article describes the case of a patient with severe chronic obstructive pulmonary disease and severe carotid stenosis, who underwent carotid stenting under monitored anesthesia care with dexmedetomidine. Only one episode of bradycardia and hypotension was observed, and this was successfully treated with glycopyrrolate.
authors.affiliation: Department of General Anesthesiology, Anesthesiology Institute, Cleveland Clinic, Cleveland, OH, USA. cataj@ccf.org
authors.forename: J P
authors.initials: JP
authors.lastname: Cata
authors.forename: E
authors.initials: E
authors.lastname: Folch
mesh_terms: D000368:Aged; D016893:Carotid Stenosis / Q000150:complications / Q000601:surgery*; D020927:Dexmedetomidine / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000627:therapeutic use*; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications; D012720:Severity of Illness Index; D015607:Stents
chemical_list: D006993:Hypnotics and Sedatives; D020927:Dexmedetomidine