关键词: 颈动脉支架成形术; 血流动力学损害; 危险因素; 围手术期

Abstract:

Objective To investigate risk factors for hemodynamic depression in perioperative period of carotid angioplasty and stenting (CAS). Methods A total of 86 patients who underwent CAS were enrolled. According to the patients’ intraoperative and postoperative blood pressure and heart rate, the patients were divided into no hemodynamic depression and hemodynamic depression groups. Univariate analysis was used to find the risk factors of hemodynamic depression, then the logistic regression analysis was used to determine the dependent risk factors after adjusting for age and sex. Results Among all 86 patients, 42 (48.8%) had hemodynamic depression of hypotension and bradycardia. Univariate analysis showed that hemodynamic depression was associated with the age ≥75 years (χ 2=4.076, P =0.040), severe internal carotid stenosis (70%-99%) (χ 2=5.010, P =0.029), calcified plaque (χ 2=4.432, P =0.035), the distance from stenosis to bifurcation ≤10 mm (χ 2=9.704, P =0.002), post-balloon dilatation (χ 2=6.635, P =0.025). Multivariate logistic regression analysis showed that the distance from stenosis to bifurcation ≤10 mm [odds ratio (OR) 2.487, 95% confidence interval (CI) 1.129-3.479, P =0.021], severe internal carotid stenosis (OR 1.650, 95%CI 1.142-4.156, P =0.035), post-balloon dilatation (OR 2.628, 95%CI 1.763-4.508, P =0.019) were independent risk factors of hemodynamic depression.

Conclusions Hemodynamic depression is a common complication in perioperative period of CAS. The distance from stenosis to bifurcation ≤ 10 mm, severe internal carotid stenosis (70%-99%), and post-balloon dilatation are independent risk factors of hemodynamic depression related with CAS.

Key words: Carotid angioplasty and stenting; Hemodynamic depression; Risk factor; Perioperative period