Abstract 3343: Hemodynamic Instability During Carotid Angioplasty And Stenting - Relationship Of Calcified Plaque And Its Characteristics
Background and Purpose- During carotid angioplasty and stenting (CAS), hemodynamic instability due to bradycardia and hypotension can occur and it may cause ischemic complications after procedure. The goal of this study was to investigate the risk factors of hemodynamic instability (HDI) and characteristic of calcified plaque that lead to HDI.
Methods- Thirty nine patients who had CAS were retrospectively evaluated for HDI. Prolonged HDI was analyzed with the relation of characteristics of calcified plaque such as eccentric and invasiveness.
Results- Nineteen (48.7%) patients had HDI. Ten of the 19 had bradycardia and hypotension together and nine of the 19 had only bradycardia. Every bradycardia was treated well with transcutaneous temporary cardiac pacemaker. But eight patients presented with prolonged hypotension (lasting for over 30 minutes) in spite of recovery of bradycardia. A calcified plaque was a related factor associated with HDI (Odds Ratio, 8.571; 95% Confidence lnterval, 1.321 to 55.62; p = .024). Extensive plaque, eccentric and invasive calcified plaque was associated with prolonged hypotension (p = .04, p = .028, p = .028 respectively)
Conclusion- The calcification of plaque is a reliable factor for HDI during and after CAS and its extensive plaque, eccentric and invasive calcified plaque may be related to the prolonged HDI.
- © 2012 by American Heart Association, Inc.