Aggressive inflation pressure (>7 atm) (OR 7.372, p=0.035) and 5 mm balloon for pre-dilatation (OR 3.527, p=0.023) were significant independent risk factors for long-period hemodynamic instability after CAS.
Cohort (n=168)
No
What are the peri-procedural risk factors and clinical outcomes of long-period hemodynamic instability after carotid artery stenting?
Long-period hemodynamic instability after carotid artery stenting is common (25%) and is driven by procedural factors such as aggressive inflation pressure and larger stents, leading to an increased risk of transient ischemic attack.
Odds Ratio: 7.372
p-value: p=0.035
Objectives The aim of this study is to identify the peri-procedural risk factors and outcomes of hemodynamic instability (HI) after carotid artery stenting (CAS). Methods A single-center, retrospective study was performed in 168 patients who underwent CAS procedure between September 2017 and September 2020. The presence of HI, as defined by hypertension (systolic blood pressure >160 mmHg), hypotension (systolic blood pressure 7 atm) and 5 mm balloon for pre-dilatation were risk factors of long-period HI (OR, 7.372, p = 0.035; OR, 3.527, p = 0.023). Intraoperative peak blood pressure and larger-sized stents remained independent predictors for the development of HI (OR, 1.043, p = 0.027, and OR, 1.973, p = 0.015). Patients with prolonged HI were more likely to suffer TIA and stroke compared to other patients and significant difference was found in the occurrence of TIA ( p < 0.05). Non-significance was found in mortality rate and other outcomes. Conclusions CAS-induced HI occurs in a considerable percentage while several peri-procedural variables are determined as independent predictors to develop long-period HI. Patients with prolonged HI are associated with increased risk of neurologic events and thus standardized intervention as well as management of long-period HI are of critical importance during clinical process.
Li et al. (2022) conducted a cohort in Carotid artery stenosis undergoing stenting (n=168). Aggressive inflation pressure (>7 atm) vs. Standard inflation pressure was evaluated on Long-period hemodynamic instability (>24 h) (OR 7.372, p=0.035). Aggressive inflation pressure (>7 atm) (OR 7.372, p=0.035) and 5 mm balloon for pre-dilatation (OR 3.527, p=0.023) were significant independent risk factors for long-period hemodynamic instability after CAS.