title: The Prevalence and Factors Contributing to Hemodynamic Depression in Patients Undergoing Carotid Angioplasty and Stenting.
abstract: BACKGROUND
  Hemodynamic depression, including bradycardia and hypotension, is among the most common complications of carotid angioplasty and stenting.
  
  
  METHODS
  A prospective, cross-sectional study was conducted at Shiraz University of Medical Sciences in southern Iran from 2011 to 2013. Consecutive patients undergoing carotid angioplasty and stenting were included. Demographic data, atherosclerotic risk factors, preprocedural blood pressure, the site of stenosis, the degree of stenosis, and data regarding technical factors were recorded. Hemodynamic depression was defined as a systolic blood pressure less than 90 mmHg and/or heart rate less than 50 beat/min.
  
  
  RESULTS
  About 170 patients (67% male, mean age: 71+9.8, 55.9% right side, 82.9% symptomatic) were recruited. Mean degree of stenosis was 79.4% in operated side and 40.7% in nonoperated side. Predilation, postdilation, or both were conducted in 18(10.5%), 141(83%), 11(6.5%) patients respectively. Thirteen (7.6%), 41(24%), and 12(7%) of patients developed postprocedural bradycardia, hypotension or both, respectively. Two patients had a stroke after CAS and periprocedural mortality was 0%. Hemodynamic depression after CAS had a significant association with preprocedure blood pressure and the use of an open cell stent design, but not with atherosclerotic risk factors, site and/or degree of stenosis, predilation, or postdilation. Hemodynamic depression significantly increased hospital stay too.
  
  
  CONCLUSIONS
  Preprocedural hydration and close-cell stents may decrease the risk of poststenting hemodynamic depression.
authors.affiliation: Clinical Neurology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran ; Departments of Neurolog,y, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: Afshin
authors.initials: A
authors.lastname: Borhani Haghighi
authors.affiliation: Departments of Neurolog,y, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: Safoora
authors.initials: S
authors.lastname: Kokabi
authors.affiliation: Non communicable diseases research center, Fasa University of Medical Sciences, Fasa, Iran.
authors.forename: Samaneh
authors.initials: S
authors.lastname: Yousefi
authors.affiliation: Transgenic Technology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: Mehrdad
authors.initials: M
authors.lastname: Emami
authors.affiliation: Clinical Neurology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran ; Departments of Neurolog,y, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: Abdolhamid
authors.initials: A
authors.lastname: Shariat
authors.affiliation: Clinical Neurology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran ; Departments of Neurolog,y, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: Alireza
authors.initials: A
authors.lastname: Nikseresht
authors.affiliation: Clinical Neurology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran ; Departments of Neurolog,y, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: Nahid
authors.initials: N
authors.lastname: Ashjazadeh
authors.affiliation: Clinical Neurology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran ; Departments of Neurolog,y, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: Sadegh
authors.initials: S
authors.lastname: Izadi
authors.affiliation: Clinical Neurology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran ; Departments of Neurolog,y, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: Peyman
authors.initials: P
authors.lastname: Petramfar
authors.affiliation: Clinical Neurology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran ; Departments of Neurolog,y, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: Maryam
authors.initials: M
authors.lastname: Poursadegh
authors.affiliation: Clinical Neurology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran ; Departments of Neurolog,y, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: Abbas Rahimi
authors.initials: AR
authors.lastname: Jaberi
authors.affiliation: Department of Neurology, Faculty of Medicine, Jahrom University of Medical Sciences, Jahrom, Iran.
authors.forename: Sajjad
authors.initials: S
authors.lastname: Emami
authors.affiliation: Neurologist, Shahidzadeh Hospital, Behbahan, Iran.
authors.forename: Hamid
authors.initials: H
authors.lastname: Agheli
authors.affiliation: Department of Neurology, Faculty of Medicine, Bushehr University of Medical Sciences, Bushehr, Iran.
authors.forename: Reza
authors.initials: R
authors.lastname: Nemati
authors.affiliation: Department of Neurology, Faculty of Medicine, Yasuj University of Medical Sciences, Yasuj, Iran.
authors.forename: Ehsan
authors.initials: E
authors.lastname: Yaghoubi
authors.affiliation: Department of Neurology, Faculty of Medicine, Fasa University of Medical Sciences, Fasa, Iran.
authors.forename: Kaveh
authors.initials: K
authors.lastname: Kashani
authors.affiliation: Neurologist, Ordibehesht Hospital, Shiraz, Iran.
authors.forename: Majid
authors.initials: M
authors.lastname: Panahandeh
authors.affiliation: Department of Neurology, Faculty of Medicine, Rafsanjan University of Medical Sciences, Rafsanjan, Iran.
authors.forename: Seyed Moslem
authors.initials: SM
authors.lastname: Heidari-Khormizi
authors.affiliation: Departments of Neurology, Texas Tech University, El Paso, TX, USA.
authors.forename: Salvador
authors.initials: S
authors.lastname: Cruz-Flores
authors.affiliation: Departments of Neurology and Psychiatry, Saint Louis University, Saint Louis, MO, USA.
authors.forename: Randal
authors.initials: R
authors.lastname: Edgell
keywords: angioplasty; bradycardia; carotid; hemodynamics; hypotension; ischemic; stenosis; stenting; stroke