ABSTRACT
Carotid artery stenosis is an important risk factor for ischemic stroke. Stenting with percutaneous techniques is routinely applied as an alternative to surgical endarterectomy in the treatment of such lesions. In such procedures, perioperative and postoperative life-threatening hemodynamic disorders can be seen. Procedural complications show an increasing learning curve with adequate theoretical knowledge and experience. In this case report, the treatment approach for deep bradycardia and hypotension developing in a patient who underwent carotid artery stenting is described.
References
1Faries PL, Chaer RA, Patel S, Lin SC, DeRubertis B, Kent KC. Current management of extracranial carotid artery disease. Vasc Endovascular Surg 2006;40(3):165-175.
2Selcuk İ, Selcuk N, Can MF, Yılmaz AT, et al. Comparison of Mid-, and Late- Term Morbidity and Mortality Results of Surgical Endarterectomy Versus Endovascular Stent Implantation in Carotid Artery Stenosis.GKDA Derg 2021;27(2):155-160.
3Brown MM. Should carotid stenting replace carotid endarterectomy in routine clinical practice? Pract Neurol 2008;8(1):39-45.
4Aboyans V, Ricco JB, Bartelink MEL, Bjorck M, Brodmann M, Cohnert T, et al. 2017 ESC Guidelines on the Diagnosis and Treatment of Peripheral Arterial Diseases, in collaboration with the European Society for Vascular Surgery (ESVS). Rev Esp Cardiol (Engl Ed) 2018;71(2):111.
5Dangas G, Laird JR Jr, Satler LF, Mehran R, Mintz GS, Larrain G, et al. Postprocedural hypotension after carotid artery stent placement: predictors and short- and long-term clinical outcomes. Radiology 2000;215(3):677-683.
6Howell M, Krajcer Z, Dougherty K, Strickman N, Skolkin M, Toombs B, et al. Correlation of periprocedural systolic blood pressure changes with neurological events in high-risk carotid stent patients. J Endovasc Ther 2002;9(6):810-816.
7Erden İA, Turgut HC, Pamuk AG, Aypar Ü. Bradiyacardia and asistole during carotid artery stenting. Anestezi Dergisi 2009;17(3):168-170.
8Sharma S, Lardizabal JA, Bhambi B. Oral midodrine is effective for the treatment of hypotension associated with carotid artery stenting. J Cardiovasc Pharmacol Ther 2008;13(2):94-97.
9Nandalur MR, Cooper H, Satler LF, Nandalur KR, Laird JR Jr. Vasopressor use in the critical care unit for treatment of persistent post-carotid artery stent induced hypotension. Neurocrit Care 2007;7(3):232-237.
10Mlekusch W, Schillinger M, Sabeti S, Nachtmann T, Lang W, Ahmadi R, et al. Hypotension and bradycardia after elective carotid stenting: frequency and risk factors. J Endovasc Ther 2003;10(5):851-859.
11Mangin L, Medigue C, Merle JC, Macquin-Mavier I, Duvaldestin P, Monti A, et al. Cardiac autonomic control during balloon carotid angioplasty and stenting. Can J Physiol Pharmacol 2003;81(10):944-951.
12Qureshi Al, Luft AR, Sharma M, Janardhan V, Lopes DK, Khan J, et al. Frequency and determinants of post procedural hemodynamic instabilitiy after carotid angioplasty and stenting. Am J Cardiol 1998;82:1077-1081.
13Berne RM, Levy MN. The peripheral circulation and its control. In: Berne RM (ed). Physiology. St. Louis: Mosby-Year Book; 1993:478-493.
14Cengiz F, Şahin H, Gökçe M. Karotis arter stentleme sonrası hipotansiyon gelişen hastaların demografik özellikleri ve olası risk faktörlerinin değerlendirilmesi. Türk Beyin Damar Hastalıkları Dergisi 2022;28(2):110-118.
15Karimova I, Kratovska A, Ponomorjova S, Buce I, Silovs A, Ligers A, et al. Prolonged hemodynamic instability with hypotension and bradycardia following carotid artery stenting: A case report. International Neuropsychiatric Disease Journal 2023;20(1):1-8.
16Huibers AE, Westerink J, de Vries EE, Hoskam A, den Ruijter HM, Moll FL, et al. Editor’s Choice - Cerebral Hyperperfusion Syndrome After Carotid Artery Stenting: A Systematic Review and Meta-analysis. Eur J Vasc Endovasc Surg 2018;56(3):322-333.
