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A Murine Model of Stent Implantation in the Carotid Artery for the Study of Restenosis
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Multivariable Analysis of Patients With Severe Persistent Postprocedural Hypotension After Carotid Artery Stenting

Olufemi Oshin1, Ramon Varcoe2, Jackie Wong1

  • 1Department of Vascular Surgery, Royal Perth Hospital, Perth, Australia.

Journal of Endovascular Therapy : an Official Journal of the International Society of Endovascular Specialists
|August 22, 2019
PubMed

Insights

Severe postprocedural hypotension (PPH) after carotid artery stenting (CAS) affects nearly a quarter of patients. Procedure complexity and stent type are key predictors of PPH risk.

Area of Science:

  • Vascular Surgery
  • Interventional Cardiology
  • Neurosurgery

Background:

  • Postprocedural hypotension (PPH) is a potential complication following carotid artery stenting (CAS).
  • Understanding the incidence and predictors of PPH is crucial for improving patient outcomes and procedural safety.

Purpose of the Study:

  • To determine the incidence of severe, persistent postprocedural hypotension (PPH) after CAS.
  • To identify predictors associated with the development of PPH in patients undergoing CAS.

Main Methods:

  • Retrospective analysis of 160 CAS procedures in 146 patients across 3 vascular centers.
  • Defined PPH as a systolic blood pressure (SBP) reduction >40 mm Hg or SBP <90 mm Hg sustained for over 1 hour post-CAS.
  • Utilized logistic regression to identify prognostic factors, presenting outcomes as odds ratios (ORs) with 95% confidence intervals (CIs).

Main Results:

  • PPH occurred in 23.1% of CAS procedures, associated with longer ICU and hospital stays.
  • Severe lesion calcification (OR 6.28) and increased contrast volume (OR 1.02) were significant predictors of PPH.
  • Specific embolic protection devices (Angioguard vs. Emboshield NAV6) and stent types (Precise vs. Xact) showed significant differences in PPH risk.

Conclusions:

  • Procedure complexity and specific stent types are significant factors in the development of PPH after CAS.
  • Contrast volume, identified as a predictor, may reflect overall procedural complexity.
  • Further research into device selection and procedural optimization is warranted to mitigate PPH risk.

Keywords:
calcificationcarotid artery stentingcontrast mediumpostprocedural hypotensionrisk factorsstenosisstent model

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