A study on related factors of hemodynamic depression in carotid artery stenting

OBJECTIVE: To investigate the pathogenesis and related factors of carotid artery stenting (CAS) related to hemodynamic depression (HD).

PATIENTS AND METHODS: 433 CAS patients were admitted to our hospital and were selected from Jan 2013 to Jun 2016. We set up the HD diagnostic criteria for CAS and observed the whole morphology of vessels to classify carotid atherosclerotic plaques. We analyzed cerebral angiography and placed temporary cardiac pacemaker via femoral vein in order to prepare carotid artery stenting. We determined the general situation of HD after CAS according to the results.

RESULTS: 38 patients received temporary placement of cardiac temporary pacemakers, and 241 patients (59.80%) developed HD. 403 patients were divided into HD group and non HD group and results suggested there was no significant difference between the two groups except for diabetes (p>0.05). Also, bilateral carotid stenting was performed in 26 patients (6.45%), and the HD group was significantly higher than that in non HD group (p<0.05). HD group had 31 MACCE cases, and non HD group had 2 MACCE cases. There was no occurrence of adverse cardiovascular events in this study.

CONCLUSIONS: Cardiac temporary pacemaker may be one of the effective approaches to improve HD after CAS and reduce perioperative MACCE.

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