Related Experiment Video

Updated: May 19, 2026

A Magnetic Resonance Imaging-based Computational Protocol for Analysis of Plaque Morphology and Hemodynamics in Patients with Carotid Artery Stenosis
09:36

A Magnetic Resonance Imaging-based Computational Protocol for Analysis of Plaque Morphology and Hemodynamics in Patients with Carotid Artery Stenosis

Published on: August 12, 2025

Hemodynamic instability after elective carotid stenting: frequency and risk factors

Dan Popescu1, Athena Mergeani, Ovidiu Alexanrdu Bajenaru

  • 1Neurology Clinic, Bucharest University Emergency Hospital, Romania.

Maedica
|August 11, 2012
PubMed

Insights

Hemodynamic instability, including hypotension and bradycardia, affects a minority of patients undergoing carotid stenting. Risk factors include extensive manipulation and beta-blocker use, but instability is not linked to neurological complications.

Area of Science:

  • Neurology
  • Cardiovascular Surgery
  • Interventional Neuroradiology

Background:

  • Carotid artery stenting (CAS) can trigger hemodynamic instability due to baroreceptor dysfunction.
  • Identifying risk factors for hemodynamic instability is crucial for patient safety during CAS.

Purpose of the Study:

  • To determine the frequency and risk factors of hemodynamic instability (hypotension/bradycardia) during elective CAS.
  • To assess the association between hemodynamic instability and neurological complications post-CAS.

Main Methods:

  • Retrospective analysis of 130 patients undergoing elective CAS with cerebral protection.
  • Defined hemodynamic instability as a systolic blood pressure drop >30 mmHg and/or bradycardia.
  • Identified risk factors including stenosis characteristics and pre-procedure medications.

Main Results:

  • 20% of patients experienced hemodynamic instability despite adequate fluid management.
  • No significant association was found between hemodynamic instability and neurological complications (9% incidence).
  • Extensive manipulation, long stenosis at bifurcation, and beta-blocker use were associated with increased risk.

Conclusions:

  • Hemodynamic instability is relatively infrequent after CAS.
  • Patients with long stenoses near the bifurcation or on beta-blockers are at higher risk.
  • Intravenous fluids did not prevent periprocedural hypotension.

Keywords:
bradycardiacarotid stenosishypotensionstroke

Related Concept Videos

Ischemic Stroke l: Introduction01:15

Ischemic Stroke l: Introduction

Ischemic stroke is an acute cerebrovascular condition in which blood flow to a brain region is suddenly interrupted, leading to tissue infarction. Neurons depend on continuous oxygen and glucose supply, so even brief reductions in perfusion cause energy failure, ionic imbalance, and irreversible injury. Ischemic strokes are classified into thrombotic and embolic types based on their underlying mechanisms.Thrombotic MechanismsThrombotic stroke develops when a clot forms within a cerebral artery.
Hemorrhagic Stroke l: Introduction01:17

Hemorrhagic Stroke l: Introduction

A hemorrhagic stroke is an acute neurological event that occurs when a weakened cerebral blood vessel ruptures, allowing blood to accumulate within or around the brain. The sudden release of blood forms a focal hematoma that increases intracranial pressure, displaces neural tissue, and can obstruct cerebrospinal fluid pathways. These effects may be compounded by intraventricular extension of the hemorrhage, cerebral edema, or compression of adjacent structures, all of which contribute to...
Transient Ischemic Attack l: Introduction01:26

Transient Ischemic Attack l: Introduction

A transient ischemic attack (TIA) is a brief episode of neurological dysfunction caused by a temporary, focal reduction in cerebral blood flow. Although symptoms resemble those of an ischemic stroke, the interruption in perfusion is short-lived and does not cause permanent infarction. TIAs are clinically important because they often serve as early warning events for future stroke.Mechanisms of Transient Cerebral IschemiaTransient cerebral ischemia may arise through several mechanisms. One...
Aortic Regurgitation I: Introduction01:15

Aortic Regurgitation I: Introduction

IntroductionAortic regurgitation is characterized by the backward flow of blood from the aorta into the left ventricle during diastole and arises from the improper closure of the aortic valve. This condition results in left ventricular volume overload and can stem from both acute and chronic etiologies, each contributing uniquely to the disease's progression and symptomatology.Acute and Chronic CausesAcute aortic regurgitation often results from events that suddenly impair the integrity of the...
Cardiac Catheterization IV: Nursing Management01:26

Cardiac Catheterization IV: Nursing Management

Nursing responsibilities before cardiac catheterization include:Assess for allergies and establish baseline health status.Before cardiac catheterization, assess the patient for allergies to contrast dye. Perform a comprehensive baseline assessment, including vital signs, heart and breath sounds, and a neurovascular assessment of the extremities, noting distal pulses, skin color, and temperature. Instruct the patient to fast for 8-12 hours before the procedure. Evaluate baseline laboratory...
Hemorrhagic Stroke ll: Pathophysiology01:29

Hemorrhagic Stroke ll: Pathophysiology

A hemorrhagic stroke develops when a cerebral blood vessel ruptures, allowing blood to escape into the surrounding brain tissue, as in intracerebral hemorrhage (ICH), or into the subarachnoid space, as in subarachnoid hemorrhage (SAH). Because the skull is a rigid compartment, the sudden presence of extravascular blood rapidly increases intracranial pressure and compresses adjacent neural structures, leading to immediate tissue injury and impaired cerebral perfusion.Mass Effect and Primary...