Hemodynamic depression during carotid angioplasty with stenting: potential risk factors determined by multidetector computed tomography angiography and related clinical factors
Kyu-Won Hwang1, Sang-Il Suh, Woo Keun Seo
1Department of Diagnostic Radiology, Korea University College of Medicine, Seoul, Korea.
Insights
Smaller total plaque volume on multidetector computed tomography (MDCT) angiography may predict hemodynamic depression (HD) during carotid angioplasty with stenting (CAS). MDCT can help identify patients at risk for HD during CAS procedures.
Area of Science:
- Cardiovascular Imaging
- Interventional Cardiology
- Radiology
Background:
- Hemodynamic depression (HD) is a potential complication during carotid angioplasty with stenting (CAS).
- Identifying predictive factors for HD is crucial for patient safety during CAS.
Purpose of the Study:
- To investigate risk factors for HD in elective CAS using multidetector computed tomography (MDCT) angiography and clinical data.
- To determine if MDCT findings can predict periprocedural HD.
Main Methods:
- Retrospective study of 32 patients undergoing MDCT angiography before CAS.
- Analysis of MDCT parameters (plaque volume, composition, stenosis degree, location) and clinical data.
- Correlation of parameters with periprocedural HD (defined by blood pressure or heart rate criteria).
Main Results:
- Periprocedural HD occurred in 28.1% of patients.
- Patients with HD had a significantly smaller total plaque volume on MDCT compared to stable patients (P=0.04).
- No other MDCT parameters or clinical data showed significant differences between groups.
Conclusions:
- Total plaque volume on MDCT angiography was the only significant predictor of HD during CAS in this study.
- MDCT angiography is a useful tool for predicting HD during CAS.
Objective:
To investigate potential risk factors for hemodynamic depression (HD) in elective carotid angioplasty with stenting (CAS) by using multidetector computed tomography (MDCT) angiographic findings and clinical data.
Methods:
A retrospective study was conducted for 32 patients that underwent MDCT angiography before CAS in our hospital. We reviewed the MDCT angiographic findings to evaluate parameters including total plaque volume, composition and the composition ratio of plaque, degree of stenosis, and distance of the most stenotic portion from carotid bifurcation. Clinical data such as patient age, presence of neurological symptoms, underlying medical disease, smoking history, and previous stroke history were noted. The MDCT angiographic parameters and clinical data were then analyzed to determine a prediction for periprocedural HD (systolic blood pressure, <90 mm Hg; or heart rate, <40 beats/min).
Results:
Periprocedural HD was observed in 9 patients (28.1%). Among the MDCT angiographic parameters, the hemodynamic unstable group of patients had a smaller total plaque volume than that of stable group of patients (P = 0.04). The other MDCT parameters and clinical data did not show statistically significant difference between 2 groups.
Conclusions:
In this study, only the total volume of plaque was a positive factor for predicting HD during CAS. Multidetector computed tomography angiography can be helpful for predicting HD during CAS.
