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Journal of Neurology

Erschienen in:

29.06.2020 | Original Communication

Hemodynamic changes between different anatomically designed stents after carotid stenting: a prospective multicenter study

verfasst von: JianFeng Han, JianLin Liu, Wei Liu, JinHua Zhang, Jiang Cheng, Chao Liu, Yang Han, Lin Yang

Erschienen in: Journal of Neurology | Ausgabe 11/2020

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Abstract

Background

The aim of this study was to investigate differences in the dynamic changes and risk factors of hemodynamic depression (HD) between straight and tapered carotid stenting (SCS and TCS, respectively).

Methods

A total of 148 and 167 patients were included in TCS and SCS groups in this study, respectively. All clinical data were collected and analyzed for differences in HD and primary endpoint events at 12 months.

Results

The SCS procedure had a lower predilation rate and a higher incidence of intra- and postprocedure HD; furthermore, the decline in heart rate in the SCS procedure was higher in patients with intra- and postprocedure HD (P < 0.05). Right stenosis [odds ratio (OR) 1.67] and stent type (ev3) (OR 2.31) were confirmed as risk factors, and older age (> 70 years) was accompanied by a lower risk (OR 0.58; P < 0.05). The SCS procedure had a higher incidence of bradycardia and hypotension after 24 h and a longer duration of hypotension (P < 0.05). Stenosis (> 80%) (OR 1.68), the SCS procedure (OR 1.72), and alcohol intake (OR 2.38) were defined as risk factors. There was no difference in the complications or clinical endpoint events in either procedure, and the restenosis rate was lower in the TCS procedure (1.35% vs 5.42%).

Conclusion

Our results reveal that TCS has a lower incidence of HD and that intra- and postprocedure HD have different manifestations and risk factors.

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Roger VL, Go AS, Lloyd-Jones DM, Adams RJ, Berry JD, Brown TM et al (2011) Heart disease and stroke statistics-2011 update: a report from the American Heart Association. Circulation 123:e18–209PubMedCrossRef

Ederle J, Dobson J, Featherstone RL, Bonati LH, van der Worp HB, de Borst GJ, International Carotid Stenting Study investigators et al (2010) Carotid artery stenting compared with endarterectomy in patients with symptomatic carotid stenosis (International Carotid Stenting Study): an interim analysis of a randomised controlled trial. Lancet 375:985–997PubMedCrossRef

Brott TG, Hobson RW, Howard G, Roubin GS, Clark WM, Brooks W, CREST Investigators et al (2010) Stenting versus endarterectomy for treatment of carotid artery stenosis. N Engl J Med 363:11–23PubMedPubMedCentralCrossRef

Bersin RM, Stabile E, Ansel GM, Clair DG, Cremonesi A, Hopkins LN et al (2012) A meta-analysis of proximal occlusion device outcomes in carotid artery stenting. Catheter Cardiovasc Interv 80:1072–1078PubMedCrossRef

Ringleb PA, Allenberg J, Brückmann H, Eckstein HH, Fraedrich G, Hartmann M et al (2006) 30 day results from the SPACE trial of stent-protected angioplasty versus carotid endarterectomy in symptomatic patients: a randomised non-inferiority trial. Lancet 368:1239–1247PubMedCrossRef

Bonati LH, Dobson J, Featherstone RL, Ederle J, van der Worp HB, de Borst GJ et al (2015) Long-term outcomes after stenting versus endarterectomy for treatment of symptomatic carotid stenosis: the International Carotid Stenting Study (ICSS) randomised trial. Lancet 385:529–538PubMedPubMedCentralCrossRef

Gensicke H, van der Worp HB, Nederkoorn PJ, Macdonald S, Gaines PA, van der Lugt A et al (2015) Ischemic brain lesions after carotid artery stenting increase future cerebrovascular risk. J Am Coll Cardiol 65:521–529PubMedPubMedCentralCrossRef

de Donato G, Setacci F, Sirignano P, Galzerano G, Cappelli A, Setacci C (2013) Optical coherence tomography after carotid artery stenting: rate of stent malapposition, plaque prolapse and fibrous cap rupture according to stent design. Eur J Vasc Endovasc Surg 45:579–587PubMedCrossRef

Simonte G, Beatrice B, Isernia G, Parlani G, Verzini F, Cieri E et al (2017) Long-term results of tapered stents in endovascular treatment of carotid stenosis. Ann Vasc Surg 45:79–84PubMedCrossRef

10.

Rosenfield K, Matsumura JS, Chaturvedi S, Riles T, Ansel GM, Metzger DC et al (2016) Randomized trial of stent versus surgery for asymptomatic carotid stenosis. N Engl J Med 374:1011–1020PubMedCrossRef

11.

Arhuidese IJ, Ottinger ME, Shukla AJ et al (2020) Hemodynamic events during carotid stenting are associated with significant periprocedural stroke and adverse events. J Vasc Surg 71(1941–53):e1

12.

Gökçal E, Niftaliyev E, Deniz Ç et al (2017) Prolonged hypotension after carotid artery stenting: incidence, predictors and consequences. Acta Neurochir (Wien) 159:2081–2087CrossRef

13.

Liu JL, Han JF, Yang L, Li YZ (2018) Short-term outcome of straight vs tapered carotid stenting for symptomatic carotid artery stenosis: a prospective study. J Endovasc Ther 25:765–770PubMedCrossRef

14.

Higashida RT, Meyers PM, Phatouros CC, Connors JJ 3rd, Barr JD, Sacks D (2004) Reporting standards for carotid artery angioplasty and stent placement. J Vasc Interv Radiol 15:421–422PubMedCrossRef

15.

The European Carotid Surgery Trialists’ Collaborative Group (1998) Randomised trial of endarterectomy for recently symptomatic carotid stenosis: final results of the MRC European Carotid Surgery Trial (ECST). Lancet 351:1379–1387CrossRef

16.

Diehm N, Katzen BT, Dick F, Kovacs M, Zemel G, Powell A et al (2008) Influence of stent type on hemodynamic depression after carotid artery stent placement. J Vasc Interv Radiol 19:23–30PubMedCrossRef

17.

Gröschel K, Ernemann U, Riecker A, Schmidt F, Terborg C, Kastrup A (2005) Incidence and risk factors for medical complications after carotid artery stenting. J Vasc Surg 42:1101–1106PubMedCrossRef

18.

Bouri S, Thapar A, Shalhoub J, Jayasooriya G, Fernando A, Franklin IJ et al (2011) Hypertension and the post-carotid endarterectomy cerebral hyperperfusion syndrome. Eur J Vasc Endovasc Surg 41:229–237PubMedCrossRef

19.

Taha MM, Sakaida H, Asakura F, Maeda M, Toma N, Sano T et al (2007) Access site complications with carotid angioplasty and stenting. Surg Neurol 68:431–437PubMedCrossRef

20.

De Rango P, Parlani G, Caso V, Verzini F, Giordano G, Cieri E et al (2010) A comparative analysis of the outcomes of carotid stenting and carotid endarterectomy in women. J Vasc Surg 51:337–344PubMedCrossRef

21.

Garciá-Nielsen L, Carreira JM, Rabellino M, Baldi S, Zander T, Gude F et al (2013) Hemodynamic depression in carotid artery stent without angioplasty. Rev Neurol 56:200–204PubMed

22.

Dangas G, Laird JR Jr, Satler LF, Mehran R, Mintz GS, Larrain G et al (2000) Postprocedural hypotension after carotid artery stent placement: predictors and short- and long-term clinical outcomes. Radiology 215:677–683PubMedCrossRef

23.

Trocciola SM, Chaer RA, Lin SC, Ryer EJ, De Rubertis B, Morrissey NJ et al (2006) Analysis of parameters associated with hypotension requiring vasopressor support after carotid angioplasty and stenting. J Vasc Surg 43:714–720PubMedCrossRef

24.

Park BD, Divinagracia T, Madej O, McPhelimy C, Piccirillo B, Dahn MS et al (2009) Predictors of clinically significant postprocedural hypotension after carotid endarterectomy and carotid angioplasty with stenting. J Vasc Surg 50:526–533PubMedCrossRef

25.

Mylonas SN, Moulakakis KG, Antonopoulos CN, Kakisis JD, Liapis CD (2013) Carotid artery stenting-induced hemodynamic instability. J Endovasc Ther 20:48–60PubMedCrossRef

26.

Gupta R, Abou-Chebl A, Bajzer CT, Schumacher HC, Yadav JS (2006) Rate, predictors, and consequences of hemodynamic depression after carotid artery stenting. J Am Coll Cardiol 47:1538–1543PubMedCrossRef

27.

Farooq MU, Goshgarian C, Min J, Gorelick PB (2016) Pathophysiology and management of reperfusion injury and hyperperfusion syndrome after carotid endarterectomy and carotid artery stenting. Exp Transl Stroke Med 8:7PubMedPubMedCentralCrossRef

Titel: Hemodynamic changes between different anatomically designed stents after carotid stenting: a prospective multicenter study
verfasst von: JianFeng Han
JianLin Liu
Wei Liu
JinHua Zhang
Jiang Cheng
Chao Liu
Yang Han
Lin Yang
Publikationsdatum: 29.06.2020
Verlag: Springer Berlin Heidelberg
Erschienen in: Journal of Neurology / Ausgabe 11/2020
Print ISSN: 0340-5354
Elektronische ISSN: 1432-1459
DOI: https://doi.org/10.1007/s00415-020-10032-0

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Hemodynamic changes between different anatomically designed stents after carotid stenting: a prospective multicenter study

Abstract

Background

Methods

Results

Conclusion

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Springer Medizin

Abstract

Background

Methods

Results

Conclusion

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