Incidence and timing of hypotension after transcervical carotid artery stenting: Correlation with postoperative complications. Issue 6 (26th July 2014)

• Record Type: Journal Article
• Authors: Cirbian, Jesús; Echaniz, Gastón; Gené, Anna; Silva, Lorena; Fernández‐Valenzuela, Valentín; de Nadal, Miriam
• Is Part Of: Catheterization and cardiovascular interventions. Volume 84:Issue 6(2014:Nov. 15)
• Page Start: 1013
• Page End: 1018
• Publication Date: 2014-07-26
• Subjects: Heart -- Diseases -- Diagnosis -- Periodicals; Cardiac catheterization -- Periodicals; 616.1207572
• DOI: 10.1002/ccd.25615
• Languages: English
• ISSNs: 1522-1946

Abstract

<abstract abstract-type="main"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="ccd25615-sec-0001" sec-type="section"> <title>Objectives</title> <p>To assess the incidence and timing of hypotension after carotid artery stenting (CAS) and its correlation with postoperative complications.</p> </sec> <sec id="ccd25615-sec-0002" sec-type="section"> <title>Background</title> <p>CAS‐associated postoperative hypotension has been linked to surgical morbidity and mortality, especially to stroke and cardiac complications.</p> </sec> <sec id="ccd25615-sec-0003" sec-type="section"> <title>Methods</title> <p>Ninety‐seven consecutive patients undergoing transcervical CAS were monitored for at least 12 hr after operation. Hypotension was defined as systolic blood pressure < 90 mm Hg. Patients were divided into three groups: normal blood pressure and early (≤6 hr) and late (>6 hr) hypotension. Complications were recorded.</p> </sec> <sec id="ccd25615-sec-0004" sec-type="section"> <title>Results</title> <p>Hypotension occurred in 34% of the patients (early hypotension in 63% of them). Hypotension was recorded in 21.6% of patients during surgery and in 21.6%, 15.5%, and 1.0% at 6, 12, and 24 hr postoperatively. Bradycardia occurred in 26.8% during operation and in 25.8%, 13.4%, and 10.3% at 6, 12, and 24 hr after surgery. Intraoperative bradycardia (<italic>P</italic> = 0.01) and hypotension (<italic>P</italic> = 0.02) were predictors of postoperative hypotension. The overall rate of complications was 5% without differences between the study groups. The mean length of stay was 3, 3.6, and 2.8 days in the normotensive, early hypotension, and late hypotension groups, respectively.</p> </sec> <sec id="ccd25615-sec-0005" sec-type="section"> <title>Conclusions</title> <p>Most postoperative hypotension episodes occurred within the first 6 hr, and more than one‐third between the 6 and 12 hr post‐procedure. All patients with late hypotension were asymptomatic. There was no difference in complications between the study groups. In patients undergoing ambulatory CAS, hemodynamic monitoring in the postoperative period is particularly important during the first 12 hr. © 2014 Wiley Periodicals, Inc.</p> </sec> </abstract>