Postprocedural hypotension after carotid artery stent placement: Predictors and short- and long-term clinical outcomes

George Dangas, John R. Laird, Lowell F. Satler, Roxana Mehran, Gary S. Mintz, German Larrain, Alexandra J. Lansky, Luis Gruberg, Emily M. Parsons, Robert Laureno, Lee H. Monsein, Martin B. Leon

Research output: Contribution to journalArticlepeer-review

132 Scopus citations

Abstract

PURPOSE: To describe the predictors of persistent hypotension after carotid artery stent (CAS) placement and define the clinical outcome of patients with this hemodynamic disturbance. MATERIALS AND METHODS: One hundred forty CAS procedures were performed in 133 consecutive patients. Post-CAS hypotension - defined as a greater than 40 mm Hg decrease in arterial pressure without evidence of hypovolemia, with a systolic pressure lower than 90 mm Hg at the end of CAS and lasting at least 1 hour - was observed in 25 patients (group 1); 108 patients did not have hypotension (group 2). RESULTS: Post-CAS hypotension developed in 33.9% of cases after balloon-expandable stent placement versus in 13.6 of cases after self- expanding stent placement (P = .04). In-hospital minor ipsilateral strokes occurred in 16% of cases in group 1 versus in 3% of cases in group 2 (P = .03). There was one (0.9%) major stroke (transient) and three (2.6%) transient ischemic attacks, all of which occurred in group 2 (not significant vs group 1 for both conditions). At 10 months ± 4 (SD) of follow-up, there was greater total mortality in group 1 than in group 2 (20% vs 4%, P = .02), whereas neurologic events did not differ significantly between the groups. CONCLUSION: Hypotension due to carotid sinus stimulation is frequent after CAS with balloon-expandable stents. This phenomenon correlates with increased inhospital complications and long-term risk of death.

Original languageEnglish (US)
Pages (from-to)677-683
Number of pages7
JournalRadiology
Volume215
Issue number3
StatePublished - Jun 2000
Externally publishedYes

Keywords

  • Arteries, transluminal angioplasty
  • Carotid arteries, angiography
  • Carotid arteries, flow dynamics
  • Carotid arteries, interventional procedures
  • Carotid arteries, US

ASJC Scopus subject areas

  • Radiological and Ultrasound Technology

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