Hemodynamic depression in carotid artery stent without angioplasty

• Published in: Revista de neurologiá Vol. 56; no. 4; pp. 200 - 204
• Main Authors: Garciá-Nielsen, Luis, Carreira, José M, Rabellino, Martín, Baldi, Sebastián, Zander, Tobías, Gude, Francisco, Pumar, José M, Maynar-Moliner, Manuel
• Format: Journal Article
• Language: Spanish
• Published: Spain 16.02.2013
• Subjects: Adult; Aged; Aged, 80 and over; Angioplasty; Carotid Stenosis - physiopathology; Carotid Stenosis - surgery; Female; Hemodynamics; Humans; Male; Middle Aged; Stents
• ISSN: 1576-6578
• DOI: 10.33588/rn.5604.2012637

Hemodynamic depression is a frequent complication related to carotid artery stenting with angioplasty. The aim of this study was to assess our results regarding hemodynamic depression, in patients who underwent carotid artery stenting without angioplasty. Between October 2002 and April 2010, 261 carotid stenosis (in 242 patients) were treated with the use of self-expanding stents without angioplasty. Inclusion criteria were symptomatic carotid stenosis > 50%, asymptomatic carotid stenosis > 70%, and stenosis ranging between 50-70% with evidence of high risk plaque morphology or micro-embolism. Outcomes during hospitalization and 30 days after procedure were registered. Hemodynamic depression was defined as hypotension (systolic blood pressure < 90 mm Hg) or bradycardia (heart rate < 60 beats/min). During the procedure 7 (2.9%) patients presented bradycardia and 3 (1.2%) hypotension. No patient required vasopressor drugs or ICU for hemodynamic monitoring. No patient developed asystole or other types of arrhythmia. During hospitalization, hemodynamic depression was not observed in any patients. During the first 30 days post-procedure, there were 11 TIAs (4.5%), 1 disabling stroke (0.4%), 1 non disabling stroke (0.4%), and 1 death (0.4%) (1 stent thrombosis at 11 days). The incidence of hemodynamic depression is low when carotid stenting procedure is performed without balloon angioplasty. The incidence of neurological complications post procedure was also low. This report highlights the need for performing randomized trials comparing both techniques.