Key result
The presence of calcified plaque significantly increased the risk of hemodynamic instability during carotid angioplasty and stenting (OR 8.571, 95% CI 1.321-55.62, p=0.024).
Why the study?
Does calcified plaque predict hemodynamic instability in patients undergoing carotid angioplasty and stenting?
Observational (n=39)
No
Does calcified plaque predict hemodynamic instability in patients undergoing carotid angioplasty and stenting?
Extensive and eccentric calcified plaques are significant predictors of prolonged hemodynamic instability during carotid angioplasty and stenting.
Calcified plaque was associated with hemodynamic instability during carotid angioplasty and stenting; hypothesis-generating and requires prospective validation before guiding risk stratification.
PURPOSE: During carotid angioplasty and stenting (CAS), hemodynamic instability (HDI) can occur, possibly causing post-procedural ischemic complications. The goal of this study was to investigate the risk factors of HDI focusing on characteristics of plaque. MATERIALS AND METHODS: Thirty nine CAS patients were retrospectively evaluated for HDI. Prolonged HDI that lasted over 30 minutes was analyzed in relation to characteristics of calcified plaque. RESULTS: Nineteen (48.7%) patients had HDI. Ten of the 19 had both bradycardia and hypotension, and nine had only bradycardia. All bradycardia was treated well with a transcutaneous temporary cardiac pacemaker. But eight patients presented with prolonged hypotension in spite of recovery of bradycardia. Calcified plaque was a related factor associated with HDI (odds ratio, 8.571; 95% confidence interval, 1.321-55.62; p=0.024). Extensive and eccentric type calcified plaques were associated with prolonged hypotension (p=0.04, and p=0.028, respectively). CONCLUSION: The calcification of plaque is a predictable factor of HDI during CAS, and its extensive and eccentric calcified plaques may be related to prolonged HDI.
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Jeon et al. (2013) conducted an observational in Carotid artery stenosis undergoing angioplasty and stenting (n=39). Calcified plaque vs. Non-calcified plaque was evaluated on Hemodynamic instability (systolic blood pressure <90 mm Hg or heart rate <50 bpm) (OR 8.571, 95% CI 1.321-55.62, p=0.024). The presence of calcified plaque significantly increased the risk of hemodynamic instability during carotid angioplasty and stenting (OR 8.571, 95% CI 1.321-55.62, p=0.024).
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