Predictors and timing of hypotension and bradycardia after carotid artery stenting.

AJNR. American Journal of Neuroradiology
P LavoieY P Gobin

Abstract

Hypotension and bradycardia are common in carotid artery stenting (CAS) and are particularly worrisome in the high risk patient who is typically referred for CAS. The purpose of this work was to assess the incidence and predictors of hypotension and bradycardia and the risk of their delayed occurrence after CAS. A total of 53 men and 40 women (median age, 71 years) with symptomatic (57%) or asymptomatic (42%) carotid artery stenosis had CAS performed in our institution between December 2002 and January 2007. Patient vital sign records for the 12 hours post-CAS were analyzed. The relative decrease of blood pressure and pulse rate were used as primary end points, and the requirement of pressor or anticholinergic drugs was used as a surrogate end point. Significant predictors of hypotension and bradycardia were analyzed with a logistic regression model. Cumulative freedom from hypotension and bradycardia was calculated by using the Kaplan-Meier method. Negative predictive value (NPV) of screening for early hypotension and bradycardia was determined. The incidence of hypotension, bradycardia, and both was 14%, 23%, and 15%, respectively. Drug intervention was required in 45 patients (48%). Asymptomatic stenosis was an independent p...Continue Reading

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Apr 5, 2013·Journal of Thrombosis and Thrombolysis·Yongkun LiXinfeng Liu
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