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Postoperative hypotension after carotid angioplasty and stenting: report of three cases

Qureshi1, Luft, Lopes

  • 1Department of Neurosurgery and Toshiba Stroke Research Center, School of Medicine and Biomedical Sciences, State University of New York at Buffalo, 14209-1194, USA.

Neurosurgery
|June 17, 1999
PubMed

Insights

Carotid angioplasty and stenting can cause prolonged hypotension and bradycardia due to carotid sinus dysfunction. Post-procedure monitoring is crucial for managing these hemodynamic complications.

Area of Science:

  • Cardiovascular Medicine
  • Interventional Neurology

Background:

  • Hemodynamic instability following carotid angioplasty and stenting (CAS) is an under-recognized complication.
  • Internal carotid artery stenosis in the carotid sinus region poses unique challenges during CAS.

Purpose of the Study:

  • To report on sustained hypotension and associated bradycardia after CAS.
  • To highlight the potential for carotid sinus dysfunction as a cause.

Main Methods:

  • Case series of three patients undergoing CAS for carotid sinus stenosis.
  • Observation of hemodynamic parameters and cardiac rhythm in the postoperative period.

Main Results:

  • All three patients experienced sustained hypotension lasting 18–33 hours post-procedure.
  • Two patients developed sinus bradycardia, one with third-degree atrioventricular block.
  • Hypotension was managed effectively with vasopressors and inotropic agents.

Conclusions:

  • Sustained hypotension and bradycardia can occur after CAS, likely due to carotid sinus dysfunction.
  • Close postoperative monitoring in a critical care setting is recommended for prompt management.

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