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Yonsei Med J. 2013 Mar 1;54(2):295-300. doi: 10.3349/ymj.2013.54.2.295.

Hemodynamic instability during carotid angioplasty and stenting-relationship of calcified plaque and its characteristics.

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  • 1Department of Neurosurgery, Hallym University College of Medicine, Chuncheon Sacred Heart Hospital, 77 Sakju-ro, Chuncheon 200-704, Korea.

Abstract

PURPOSE:

During carotid angioplasty and stenting (CAS), hemodynamic instability (HDI) can occur, possibly causing post-procedural ischemic complications. The goal of this study was to investigate the risk factors of HDI focusing on characteristics of plaque.

MATERIALS AND METHODS:

Thirty nine CAS patients were retrospectively evaluated for HDI. Prolonged HDI that lasted over 30 minutes was analyzed in relation to characteristics of calcified plaque.

RESULTS:

Nineteen (48.7%) patients had HDI. Ten of the 19 had both bradycardia and hypotension, and nine had only bradycardia. All bradycardia was treated well with a transcutaneous temporary cardiac pacemaker. But eight patients presented with prolonged hypotension in spite of recovery of bradycardia. Calcified plaque was a related factor associated with HDI (odds ratio, 8.571; 95% confidence interval, 1.321-55.62; p=0.024). Extensive and eccentric type calcified plaques were associated with prolonged hypotension (p=0.04, and p=0.028, respectively).

CONCLUSION:

The calcification of plaque is a predictable factor of HDI during CAS, and its extensive and eccentric calcified plaques may be related to prolonged HDI.

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