Carotid artery stenting-induced hemodynamic instability.
Spyridon N Mylonas1, Konstantinos G Moulakakis, Constantinos N Antonopoulos
1Department of Vascular Surgery, Athens University Medical School, Attikon University Hospital, Athens, Greece. spyrosmylonas@gmail.com
Summary
Carotid artery stenting (CAS) can cause hemodynamic instability (HI) in a significant number of patients. However, this instability does not appear to increase perioperative risks like stroke or death.
Area of Science:
- Cardiovascular Interventions
- Neurosurgery
- Clinical Trials & Epidemiology
Background:
- Carotid artery stenting (CAS) is a common procedure for treating carotid artery stenosis.
- Hemodynamic instability (HI) is a potential complication during and after CAS.
- Understanding the incidence and impact of CAS-induced HI is crucial for patient safety.
Purpose of the Study:
- To systematically review and meta-analyze the incidence of CAS-induced hemodynamic instability (HI).
- To explore differences in periprocedural risk between patients with and without CAS-associated HI.
Main Methods:
- Systematic review and meta-analysis of studies published between January 2000 and December 2011.
- Inclusion of 27 studies comprising 4204 patients undergoing CAS.
- Meta-regression analysis to identify factors associated with HI.
Main Results:
- The overall incidence of HI following CAS was 39.4%.
- Pooled estimates for hypotension and bradycardia were 12.1% and 12.2%, respectively.
- No significant differences in death, stroke, TIA, or major adverse events were observed between patients with and without HI.
Conclusions:
- CAS-induced HI is frequent but does not elevate perioperative risks.
- Prophylactic measures and close monitoring of hemodynamics are recommended for early management of HI.
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