Intravascular stent implantation is an attractive therapy for carotid artery stenosis. Severe complications of the interventional procedure however include stroke and death. Aims: It has been suggested, that episodes of temporary bradycardia and hypotension uppon balloon inflation could be related to adverse outcome. Methods: In order to assess the significance of episodic haemodynamic instability 24 consecutive patients were continuosly monitored during intravascular intervention. Heart rate and blood pressure variability parameters of the patients, and indices of spontaneous baroreflex sensitivity were determined prior to the procedures. The authors have assessed the potential correlation between the autonomic markers recorded on baseline and the subsequent occurance of reflex mediated haemodynamic instability. Results: The authors observations confirmed that bradycardia and hypotension occures frequently at the time of stent after-dilation. Pausas in excess of 3 seconds occured in 29% of patients. Atropin was administered at 7 instances. The magnitude of systolic blood pressure drop was greater among patients with pausas, however substantial pressue drop was seen among those without pausas as well. No severe complications were seen. Heart rate variability and spontaneous baroreflex sensitivity were reduced in the whole studied population, allowing no prediction of episodes with bradycardia and hypotension. Conclusion: The authors findings indicate that reflex mediated haemodynamic instability induced by carotid artery intervention is a benign phenomenon. Analysis of autonomic markers is of limited value in this patient population.
|Number of pages||7|
|Publication status||Published - Dec 31 2006|
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