Blood pressure-lowering effect of carotid artery stenting in patients with symptomatic carotid artery stenosis.
BACKGROUND
In patients with symptomatic carotid artery stenosis, long-term effects of carotid artery stenting (CAS) on blood pressure (BP) changes have not been documented well. We evaluated the effects of CAS on BP and found out its predisposing factors in patients with symptomatic carotid artery stenosis.


METHODS
Between January 2003 and June 2012, a total of 107 patients were recruited, and all subjects met the following inclusion criteria: (1) patients underwent CAS with symptomatic carotid artery stenosis > 50%; (2) patients had clinical and radiographic data for at least 1 year of follow-up after CAS; and (3) patients had BP measurements at four different time points: pretreatment, post-treatment, 1-month follow-up, and 1-year follow-up. We evaluated the significance of the BP changes between the pretreatment BP and follow-up BPs, and determined its predisposing factors.


RESULTS
Compared to the mean systolic/diastolic BP value (141.0/87.4 mmHg) at the pretreatment BP, the follow-up BPs were significantly decreased after CAS (120.5/74.5, 126.2/76.9, and 129.2/79.0 mmHg at the post-treatment, the 1-month follow-up, and the 1-year follow-up, respectively [p < 0.01]). The location of the stenosis (odds ratio = 1.856, 95% confidence interval, 1.388 to 5.589; p = 0.003) and hypertension (odds ratio = 1.627, 95% confidence interval, 1.101 to 3.757; p = 0.014) were independent predisposing factors for BP-lowering effects of CAS on multivariate analysis.


CONCLUSIONS
For patients with symptomatic carotid artery stenosis, CAS might have a BP-lowering effect at the 1-year follow-up, especially in patients with hypertension or the stenosis at body lesions.
Department of Neurosurgery, Gangnam Severance Hospital, Yonsei University College of Medicine, 211, Eonjuro, Gangnam-gu, Seoul,, 135-720, Republic of Korea.
Joonho
J
Chung
Yong Bae
YB
Kim
Chang-Ki
CK
Hong
Sang Hyun
SH
Suh
Eui-Young
EY
Choi
Hun Jae
HJ
Lee
Yong Cheol
YC
Lim
Yong Sam
YS
Shin
Jin-Yang
JY
Joo
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000800:Angioplasty, Balloon; D001794:Blood Pressure / Q000502:physiology*; D002339:Carotid Arteries / Q000473:pathology / Q000601:surgery*; D016893:Carotid Stenosis / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000628:therapy; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012307:Risk Factors; D015607:Stents; D016896:Treatment Outcome