title: Incidence of hemodynamic depression after carotid artery stenting using different self-expandable stent types.
abstract: The rates of hemodynamic depression (HD) and thromboembolism were compared in 95 carotid artery stenting (CAS) procedures performed in 87 patients with severe carotid artery stenosis using self-expandable braided Elgiloy stents (Wallstent) in 52 and slotted-tube Nitinol stents (Precise) in 43 procedures. The blood pressure, pulse rate, and neurological signs were recorded at short intervals during and after CAS. All patients underwent diffusion-weighted magnetic resonance imaging within 5 days after the procedure. The incidences of hypotension, bradycardia, and both were 17.9%, 3.2%, and 11.6%, respectively. The rate of postprocedural HD was 23.1% with Wallstent and 44.2% with Precise; the difference was significant (p = 0.025). No patient manifested major cardiovascular disease after CAS. Diffusion-weighted magnetic resonance imaging revealed thromboembolism after 26.9% and 34.9% of Wallstent and Precise stent placement procedures, respectively; the difference was not significant. The type of self-expandable stent placed may affect the risk of procedural HD in patients undergoing CAS. Postprocedural HD was resolved successfully by the administration of vasopressors and by withholding antihypertensive agents.
authors.affiliation: Department of Neurosurgery, Fukuoka University Chikushi Hospital, Chikushino, Fukuoka, Japan.
authors.forename: Kouhei
authors.initials: K
authors.lastname: Nii
authors.forename: Masanori
authors.initials: M
authors.lastname: Tsutsumi
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Aikawa
authors.forename: Shuko
authors.initials: S
authors.lastname: Hamaguchi
authors.forename: Housei
authors.initials: H
authors.lastname: Etou
authors.forename: Kimiya
authors.initials: K
authors.lastname: Sakamoto
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Kazekawa
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001919:Bradycardia / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology; D016893:Carotid Stenosis / Q000150:complications / Q000453:epidemiology / Q000628:therapy; D002548:Cerebral Revascularization / Q000009:adverse effects* / Q000295:instrumentation; D005260:Female; D006801:Humans; D007022:Hypotension / Q000188:drug therapy / Q000453:epidemiology* / Q000209:etiology; D015994:Incidence; D008297:Male; D011183:Postoperative Complications / Q000453:epidemiology* / Q000503:physiopathology; D012189:Retrospective Studies; D015607:Stents / Q000009:adverse effects* / Q000145:classification