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Related Experiment Video

Updated: May 5, 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

836

Predictive Nomogram for Prolonged Hemodynamic Instability After Carotid Artery Stenting.

Mingxing Liu1, Yong Zhou1, Tong Li1

  • 1Department of Neurosurgery, Qingdao Hospital, University of Health and Rehabilitation Sciences (Qingdao Municipal Hospital), Qingdao, Shandong Province, P.R. China.

Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions
|May 4, 2026
PubMed
Summary

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Intraoperative hemodynamic instability (HI), large balloons, 7-10mm stents, and post-balloon dilation predict prolonged HI after carotid artery stenting (CAS). A new nomogram aids in preoperative risk stratification for CAS patients.

Area of Science:

  • Cardiovascular Interventions
  • Vascular Surgery
  • Neurosurgery

Background:

  • Hemodynamic instability (HI), characterized by hypotension and/or bradycardia, is a frequent complication within 6 hours post-carotid artery stenting (CAS).
  • Prolonged HI necessitates careful management due to an elevated risk of neurological complications.

Purpose of the Study:

  • To determine the incidence of prolonged hemodynamic instability (HI) following CAS.
  • To identify potential predictive factors for prolonged HI after CAS.

Main Methods:

  • A retrospective study involving patients undergoing CAS from January 2023 to January 2025.
  • Logistic regression analysis was employed to identify predictors of prolonged HI, with a nomogram developed for risk stratification.
  • Predictive performance was assessed using ROC, Hosmer-Leme, and decision curve analyses.
Keywords:
carotid artery stentinglogistic regressionnomogramprolonged hemodynamic instability

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Last Updated: May 5, 2026

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Main Results:

  • Intraoperative HI, use of large balloons, 7-10mm stents, and post-balloon dilatation were identified as significant independent predictors of prolonged HI.
  • The developed nomogram demonstrated high predictive accuracy in both training and validation cohorts (AUC=0.92).
  • The nomogram proved superior to the All or None scheme in decision curve analysis for risk stratification.

Conclusions:

  • Intraprocedural HI, large balloons, large-diameter stents (7-10mm), and post-balloon dilatation are independent risk factors for prolonged HI post-CAS.
  • The developed nomogram offers a precise tool for preoperative risk stratification in patients undergoing CAS.
  • This tool can aid clinicians in anticipating and managing prolonged HI, potentially reducing associated neurological complications.