[Clinical characteristics and risk factors of hemodynamic depression after carotid angioplasty and stenting].

OBJECTIVE:To investigate the carotid angioplasty and stenting (CAS)-induced hemodynamic depression (HD) and its impact on postprocedural complications so as to identify its risk factors. METHODS:The incidence, onset time, duration and severity of HD were observed in 196 CAS patients. The influences of clinical baseline and vascular angiographic characteristics on HD were recorded and the relationship between HD and postprocedural complications was analyzed. Logistic regression analysis was used to identify the independent risk factors of HD. RESULTS:The incidence of HD was 53.1%. Most cases of HD (67.3%) developed within 1 - 16 hours postprocedural. And 55.8% HD lasted for over 24 hours and became relieved within 3 - 16 days post-operation. And 78.9% HD patients required medications for the controls of blood pressure and heart rate. Diabetes, hypertension, smoking, plaque involving carotid bulb, ulcerated plaque and calcified plaque were shown to be associated with HD. Further analysis of logistic regression suggested that diabetes and smoking were two protective factors for HD while plaque involving carotid bulb and calcified plaque two independent risk factors for HD. The HD patients were at an increased risk of neurological and cardiopulmonary complications. CONCLUSION:With a high post-CAS incidence after CAS, HD is associated with postprocedural complications. Lesions involving carotid bulb and calcified plaque are two independent risk factors for HD.