Role of stent selection in the incidence of persisting hemodynamic depression after carotid artery stenting

Csaba Csobay-Novák, Tamás Bárány, E. Zima, B. Nemes, P. Sótónyi, B. Merkely, Kálmán Hüttl

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Purpose: To investigate the possible role of stent selection and procedure-related vessel diameter changes in the development of persisting hemodynamic depression (PHD) and to demonstrate the effectiveness and safety of permanent pacemaker implantation in patients with refractory PHD. Methods: Data from 584 procedures performed in 542 patients (398 men; mean age 67.3 years) between 2008 and 2011 using Wallstent, Precise, and Xact stents in a nonrandomized fashion were analyzed retrospectively. Cardiovascular risk factors and lesion, stent, and balloon characteristics were collected, and the pre- and postprocedure diameters of the common carotid artery (CCA) and internal carotid artery were measured. PHD was defined as any episode of hypotension (systolic blood pressure 6 hours. Risk factors for PHD were sought using logistic regression analyses; the results are presented as the odds ratio (OR) and 95% confidence interval (CI). Results: The incidence of PHD was 37.0% (216/584). Refractory PHD was encountered in 9 patients; among these, 6 were successfully treated with pacemaker implantation. A history of prior ipsilateral carotid endarterectomy (OR 0.44, 95% CI 0.22 to 0.87, p=0.019) and the presence of a contralateral high-grade stenosis (OR 0.12, 95% CI 0.02 to 0.95, p=0.045) were independent protective factors, while calcification (OR 1.5, 95% CI 1.03 to 2.18, p=0.034), involvement of the carotid bulb (OR 2.56, 95% 1.62 to 4.03, p

Original languageEnglish
Pages (from-to)122-129
Number of pages8
JournalJournal of Endovascular Therapy
Volume22
Issue number1
DOIs
Publication statusPublished - Feb 1 2015

Fingerprint

Carotid Arteries
Stents
Hemodynamics
Odds Ratio
Incidence
Confidence Intervals
Blood Pressure
Carotid Endarterectomy
Common Carotid Artery
Internal Carotid Artery
Hypotension
Pathologic Constriction
Logistic Models
Regression Analysis
Safety

Keywords

  • Baroreceptor
  • Bradycardia
  • Carotid artery
  • Carotid artery stenting
  • Hypotension
  • Nitinol stent
  • Pacemaker
  • Self-expanding stent

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Radiology Nuclear Medicine and imaging

Cite this

Role of stent selection in the incidence of persisting hemodynamic depression after carotid artery stenting. / Csobay-Novák, Csaba; Bárány, Tamás; Zima, E.; Nemes, B.; Sótónyi, P.; Merkely, B.; Hüttl, Kálmán.

In: Journal of Endovascular Therapy, Vol. 22, No. 1, 01.02.2015, p. 122-129.

Research output: Contribution to journalArticle

@article{ce871f0465524fa2adac0d1a118e65c3,
title = "Role of stent selection in the incidence of persisting hemodynamic depression after carotid artery stenting",
abstract = "Purpose: To investigate the possible role of stent selection and procedure-related vessel diameter changes in the development of persisting hemodynamic depression (PHD) and to demonstrate the effectiveness and safety of permanent pacemaker implantation in patients with refractory PHD. Methods: Data from 584 procedures performed in 542 patients (398 men; mean age 67.3 years) between 2008 and 2011 using Wallstent, Precise, and Xact stents in a nonrandomized fashion were analyzed retrospectively. Cardiovascular risk factors and lesion, stent, and balloon characteristics were collected, and the pre- and postprocedure diameters of the common carotid artery (CCA) and internal carotid artery were measured. PHD was defined as any episode of hypotension (systolic blood pressure 6 hours. Risk factors for PHD were sought using logistic regression analyses; the results are presented as the odds ratio (OR) and 95{\%} confidence interval (CI). Results: The incidence of PHD was 37.0{\%} (216/584). Refractory PHD was encountered in 9 patients; among these, 6 were successfully treated with pacemaker implantation. A history of prior ipsilateral carotid endarterectomy (OR 0.44, 95{\%} CI 0.22 to 0.87, p=0.019) and the presence of a contralateral high-grade stenosis (OR 0.12, 95{\%} CI 0.02 to 0.95, p=0.045) were independent protective factors, while calcification (OR 1.5, 95{\%} CI 1.03 to 2.18, p=0.034), involvement of the carotid bulb (OR 2.56, 95{\%} 1.62 to 4.03, p",
keywords = "Baroreceptor, Bradycardia, Carotid artery, Carotid artery stenting, Hypotension, Nitinol stent, Pacemaker, Self-expanding stent",
author = "Csaba Csobay-Nov{\'a}k and Tam{\'a}s B{\'a}r{\'a}ny and E. Zima and B. Nemes and P. S{\'o}t{\'o}nyi and B. Merkely and K{\'a}lm{\'a}n H{\"u}ttl",
year = "2015",
month = "2",
day = "1",
doi = "10.1177/1526602814566404",
language = "English",
volume = "22",
pages = "122--129",
journal = "Journal of Endovascular Therapy",
issn = "1526-6028",
publisher = "International Society of Endovascular Specialists",
number = "1",

}

TY - JOUR

T1 - Role of stent selection in the incidence of persisting hemodynamic depression after carotid artery stenting

AU - Csobay-Novák, Csaba

AU - Bárány, Tamás

AU - Zima, E.

AU - Nemes, B.

AU - Sótónyi, P.

AU - Merkely, B.

AU - Hüttl, Kálmán

PY - 2015/2/1

Y1 - 2015/2/1

N2 - Purpose: To investigate the possible role of stent selection and procedure-related vessel diameter changes in the development of persisting hemodynamic depression (PHD) and to demonstrate the effectiveness and safety of permanent pacemaker implantation in patients with refractory PHD. Methods: Data from 584 procedures performed in 542 patients (398 men; mean age 67.3 years) between 2008 and 2011 using Wallstent, Precise, and Xact stents in a nonrandomized fashion were analyzed retrospectively. Cardiovascular risk factors and lesion, stent, and balloon characteristics were collected, and the pre- and postprocedure diameters of the common carotid artery (CCA) and internal carotid artery were measured. PHD was defined as any episode of hypotension (systolic blood pressure 6 hours. Risk factors for PHD were sought using logistic regression analyses; the results are presented as the odds ratio (OR) and 95% confidence interval (CI). Results: The incidence of PHD was 37.0% (216/584). Refractory PHD was encountered in 9 patients; among these, 6 were successfully treated with pacemaker implantation. A history of prior ipsilateral carotid endarterectomy (OR 0.44, 95% CI 0.22 to 0.87, p=0.019) and the presence of a contralateral high-grade stenosis (OR 0.12, 95% CI 0.02 to 0.95, p=0.045) were independent protective factors, while calcification (OR 1.5, 95% CI 1.03 to 2.18, p=0.034), involvement of the carotid bulb (OR 2.56, 95% 1.62 to 4.03, p

AB - Purpose: To investigate the possible role of stent selection and procedure-related vessel diameter changes in the development of persisting hemodynamic depression (PHD) and to demonstrate the effectiveness and safety of permanent pacemaker implantation in patients with refractory PHD. Methods: Data from 584 procedures performed in 542 patients (398 men; mean age 67.3 years) between 2008 and 2011 using Wallstent, Precise, and Xact stents in a nonrandomized fashion were analyzed retrospectively. Cardiovascular risk factors and lesion, stent, and balloon characteristics were collected, and the pre- and postprocedure diameters of the common carotid artery (CCA) and internal carotid artery were measured. PHD was defined as any episode of hypotension (systolic blood pressure 6 hours. Risk factors for PHD were sought using logistic regression analyses; the results are presented as the odds ratio (OR) and 95% confidence interval (CI). Results: The incidence of PHD was 37.0% (216/584). Refractory PHD was encountered in 9 patients; among these, 6 were successfully treated with pacemaker implantation. A history of prior ipsilateral carotid endarterectomy (OR 0.44, 95% CI 0.22 to 0.87, p=0.019) and the presence of a contralateral high-grade stenosis (OR 0.12, 95% CI 0.02 to 0.95, p=0.045) were independent protective factors, while calcification (OR 1.5, 95% CI 1.03 to 2.18, p=0.034), involvement of the carotid bulb (OR 2.56, 95% 1.62 to 4.03, p

KW - Baroreceptor

KW - Bradycardia

KW - Carotid artery

KW - Carotid artery stenting

KW - Hypotension

KW - Nitinol stent

KW - Pacemaker

KW - Self-expanding stent

UR - http://www.scopus.com/inward/record.url?scp=84939797560&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84939797560&partnerID=8YFLogxK

U2 - 10.1177/1526602814566404

DO - 10.1177/1526602814566404

M3 - Article

C2 - 25775692

AN - SCOPUS:84939797560

VL - 22

SP - 122

EP - 129

JO - Journal of Endovascular Therapy

JF - Journal of Endovascular Therapy

SN - 1526-6028

IS - 1

ER -