Carotid Baroreceptor Reaction after Stenting in 2 Locations of Carotid Bulb Lesions of Different Embryologic Origin

Suh, Dae Chul; Kim, J.L.; Kim, E.H.; Kim, J.K.; Shin, Jiyong; Hyun, D.H.; Lee, H.Y.; Lee, D.H.; Kim, J.S.

doi:10.3174/ajnr.a2891

Cited by 17 publications

(12 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In contrast, the apex of the carotid bulb is partially confined to the carotid bulb and is less affected by stimulation of the glossopharyngeal nerve. 27) When a self-expandable stent is deployed at the stenotic lesion, a maximum force of dilatation may affect the arterial wall at the lesion of high-grade stenosis on DSA. That may be why hypotension was more frequently occurred in lesion near the carotid bifurcation.…”

Section: Discussionmentioning

confidence: 99%

Complications and Predictors of Hypotension Requiring Vasopressor after Carotid Artery Stenting

Nanto

Goto

Yamamoto

et al. 2017

Neurol. Med. Chir.(Tokyo)

View full text Add to dashboard Cite

A significant controversy exists regarding the clinical impact of hemodynamic depression on major adverse events after carotid artery stenting (CAS). The purpose of this study was to evaluate the incidence, predictors, and clinical significance of hypotension after CAS. A total of 118 cases of carotid artery stenosis were treated with CAS. Hypotension was defined as sustained systolic blood pressure <80 mmHg and requiring intravenous administration of vasopressor to maintain adequate systolic blood pressure after the procedure. Baseline characteristics, procedural characteristics, and periprocedural major adverse events were retrospectively compared between postprocedural hypotension group and non-hypotension group. Morphological and procedural characteristics were not significantly different between the two groups. Periprocedural major adverse events, presence of new ischemic lesions, and number of new ischemic lesions were not significantly different between the two groups (P = 1, P = 0.36, P = 0.68). Hypertension was an independent protective factor (P = 0.037), and use of proximal protection and the distance from carotid bifurcation to maximum stenotic lesion ≤ 10 mm were independent risk factors for developing hypotension after CAS (P = 0.034, P = 0.027). There was no significant relationship between hypotension after CAS and major adverse events in this study. Maintenance of periprocedural adequate cerebral perfusion is thought to be important to prevent ischemic complications due to hypotension after CAS, especially in these cases.

show abstract

Section: Discussionmentioning

confidence: 99%

Complications and Predictors of Hypotension Requiring Vasopressor after Carotid Artery Stenting

Nanto

Goto

Yamamoto

et al. 2017

Neurol. Med. Chir.(Tokyo)

View full text Add to dashboard Cite

show abstract

“…Степень стенозирования сонной артерии измерялась по критериям NASCET по данным селективной [9,10], апикальными поражениями считаются те, в которых поражение переходной зоны каротидной луковицы и проксимальной шейки внутренней сонной артерии происходит без или с минимальным вовлечением тела сонной артерии. Поражениями тела считается вовлечение атеросклеротического процесса в переходной зоне общей сонной артерии и каротидной луковицы.…”

Section: материал и методыunclassified

The dynamics of blood pressure within 12 months after carotid artery stenting in patients with stenotic carotid lesions

Шукуров

Bulgakova

Shapieva³

et al. 2019

Russ J Cardiol

View full text Add to dashboard Cite

Aim. To assess the dynamics of blood pressure (BP) and determine the predictors of the hypotensive effect after carotid artery stenting (CAS).Material and methods. The analysis included 99 patients who underwent CAS in a period of March 2014 and May 2016. Inclusion criteria: (1) the presence of 50% symptomatic or 70% asymptomatic stenosis of the carotid artery (according to NASCET criteria), (2) follow-up for at least 1 year, (3) measurement and recording of BP at four points: 24 hours before surgery, 1 hour, 24 hours and 12 months after surgery. Results. According to office measurement of BP, the average systolic/diastolic pressure was 117,11/60,75, 119,73/60,75, 134,75/70,48 mm Hg after 1 hour, one day and 12 months after the intervention, respectively. In comparison with the average numbers of BP before the intervention, 148,13/89,52 mm Hg there was a significantly significant decrease in BP levels after CAS (p<0,01). According to the results of daily monitoring of blood pressure, a statistically important decrease in blood pressure was observed after 1 year of observation (p<0,01) (136,52/76,84 compared with 145,91/87,63 before the intervention). Dissociated circle of Willis (odds ratio=10,37, 95% confidence interval, from 3,64 to 29,52; p<0,001) and the occurrence of intraoperative hypotension (odds ratio =3,62, 95% confidence interval, from 1,16 to 11,28; p<0,027) were predictors of a persistent decrease in BP after CAS. Conclusion. The obtained results indicated the need for more thorough conservative postoperative management, especially for patients with a dissociated circle of Willis. It is also necessary to achieve the target blood pressure values by individualized correction of antihypertensive therapy.

show abstract

“…General anesthesia is not prefered because neurologic function cannot then be evaluated during the CAS procedure. During CAS, severe bradycardia or asystole may occur due to stretching of the carotid body [ 23 , 24 , 25 ]. Anesthesiologists should be cautioned regarding this unpredictable reflex.…”

Section: Carotid Angioplasty and Stentingmentioning

confidence: 99%

Anesthetic Consideration for Neurointerventional Procedures

et al. 2014

View full text Add to dashboard Cite

Interventional neuroradiology (INR) has been a rapidly expanding and advancing clinical area during the past few decades. As the complexity and diversity of INR procedures increases, the demand for anesthesia also increases. Anesthesia for interventional neuroradiology is a challenge for the anesthesiologist due to the unfamiliar working environment which the anesthesiologist must consider, as well as the unique neuro-interventional components. This review provides an overview of the anesthetic options and specific consideration of the anesthesia requirements for each procedure. We also introduce the anesthetic management for interventional neuroradiology performed in our medical institution.

show abstract

Carotid Baroreceptor Reaction after Stenting in 2 Locations of Carotid Bulb Lesions of Different Embryologic Origin

Cited by 17 publications

References 34 publications

Complications and Predictors of Hypotension Requiring Vasopressor after Carotid Artery Stenting

Complications and Predictors of Hypotension Requiring Vasopressor after Carotid Artery Stenting

The dynamics of blood pressure within 12 months after carotid artery stenting in patients with stenotic carotid lesions

Anesthetic Consideration for Neurointerventional Procedures

Contact Info

Product

Resources

About