Incidence and predictors of prolonged hemodynamic depression after carotid artery stenting: Yet another benefit of statins?

Erkol, Ayhan; Dalgiç, Yalçın; Yıldırım, Serkan; Turan, Burak

doi:10.1016/j.clineuro.2021.106786

Cited by 5 publications

(4 citation statements)

References 43 publications

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“…A total of 1430 literature records were retrieved, including 435 records in Chinese and 995 records in English. Finally, 17 3 –5,7,10 –12,17 –26 studies were finally included in the meta-analysis. The flow of the literature screening process is shown in Figure 1.…”

Section: Resultsmentioning

confidence: 99%

“…The 17 3 –5,7,10 –12,17 –26 studies included 7 3,7,11,17 –20 case-control studies and 10 4,5,10,12,21 –26 cross-sectional studies. In addition, the sample contained a total sample size of 2843 cases, as well as 897 patients with postoperative hypotension and 14 patients with exposure factors (Table 1).…”

Section: Resultsmentioning

confidence: 99%

“…This may result in a greater risk of severe hemodynamic flow disturbances. 30,34 –36 Liu et al 18 found that bilateral CAS placement improved cerebral blood supply, thereby regulating blood pressure.…”

Section: Discussionmentioning

confidence: 99%

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Incidence and risk factors for hypotension after carotid artery stenting: Systematic review and meta-analysis

Yang

Liu

et al. 2023

International Journal of Stroke

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Objective: Hypotension is recognized as a common complication after carotid artery stenting, but its incidence and the risk factors associated with it are uncertain. Therefore, we performed a systematic review and meta-analysis to investigate and identify risk factors for hypotension after surgery. Methods: We retrieved risk factors from eight databases for case-control and cross-sectional studies of hypotension after carotid artery stenting according to PRISMA guidelines on Nov. 28th, 2022. Data were analyzed by using R4.2.1 and Review Manager 5.3. Results: A total of 2,843 samples were searched, and 17 publications were included in the analysis. The meta-analysis results showed that the incidence of hypotension after surgery was 28.6% (95% CI [0.225,0.347]). Age ≥65 years (OR=4.55, 95% CI [2.50, 8.29], P＜0.00001), stenosis site (bulb) (OR=4.41, 95% CI [2.50, 7.79], P<0.00001), severe stenosis (OR= 3.56, 95% CI [1.62, 7.85], P=0.002), stenosis proximity (≤10 mm) to bifurcation (OR=2.69, 95% CI [1.74, 4.15], P<0.00001), calcified plaques (OR=4.64, 95% CI [1.93, 11.14], P=0.0006), post-balloon dilation (OR=5.95, 95% CI [2.31, 15.31], P=0.0002), bilateral carotid stenting (OR=30.51, 95% CI [2.33, 399.89], P=0.009), and intravenous fluid intake/mL on the first postoperative day (MD=444.99, 95% CI [141.40, 748.59], P=0.004) were risk factors for hypotension after surgery. Conclusions: A high incidence of hypotension was observed after carotid artery stenting. Age, stenosis site, severe stenosis, stenosis proximity to bifurcation, calcified plaques, post-balloon dilation, type of surgery, and intravenous fluid intake were identified as risk factors.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Incidence and risk factors for hypotension after carotid artery stenting: Systematic review and meta-analysis

Yang

Liu

et al. 2023

International Journal of Stroke

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“…Long-term statin use has been shown to improve clinical and angiographic outcomes in atherosclerotic conditions undergoing stent placement in the coronary, peripheral, and cerebrovascular circulations. 3,[12][13][14] Treatment with long-term statins in patients undergoing carotid stent placement resulted in lower rates of perioperative stroke, death, myocardial infarction, and intracranial hemorrhage, with a reduction of stroke and mortality rates at 1 month. 1,15 Furthermore, several studies have demonstrated that high-dose statins could significantly reduce or slow progression of carotid intima media thickness or the plaque volume when measured by intravascular ultrasound.…”

Section: Discussionmentioning

confidence: 99%

Effect of Statin on Radiographic and Clinical Outcomes of Intracranial Aneurysms Treated With Pipeline Embolization: A Propensity Score–Matched Analysis

et al. 2023

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BACKGROUND AND OBJECTIVES: Studies have shown that use of statin can improve radiographic and clinical outcomes in patients receiving treatment for coronary artery or peripheral vascular stenosis. Statins are thought to be effective by reducing arterial wall inflammation. The same mechanism may have an influence on the efficacy of pipeline embolization device (PED) for intracranial aneurysm treatment. Although this question has been of interest, there is a lack of well-controlled data in the literature. The objective of this study is to analyze the effect of statins on outcomes of aneurysms treated with pipeline embolization through propensity score matching. METHODS: Patients who underwent PED for unruptured intracranial aneurysms at our institution between 2013 and 2020 were identified. Patients on statin treatment vs those who were not were matched through propensity score by controlling for confounding factors including age, sex, current smoking status, diabetes, aneurysm morphology, volume, neck size, location of aneurysm, history of treatment for the same aneurysm, type of antiplatelet therapy, and elapsed time at last follow-up. Occlusion status at first follow up and last follow-up, and incidence of in-stent stenosis and ischemic complications during the follow-up period were extracted for comparison. RESULTS: In total, 492 patients with PED were identified, of whom 146 were on statin therapy and 346 were not. After one-to-one nearest neighbor matching, 49 cases in each group were compared. At last follow-up, 79.6%, 10.2%, and 10.2% of cases in the statin therapy group and 67.4%, 16.3%, and 16.3% in the nonstatin group were noted to have Raymond–Roy 1, 2, and 3 occlusions, respectively (P = .45). No significant difference was observed in immediate procedural thrombosis (P > .99), long-term in-stent stenosis (P > .99), ischemic stroke (P = .62), or retreatment (P = .49). CONCLUSION: Statin use does not affect occlusion rate or clinical outcomes in patients treated with PED treatment for unruptured intracranial aneurysms.

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Recurrent dizziness due to paroxysmal atrioventricular block following carotid artery stenting in a patient with a normal atrioventricular conduction and iatrogenic carotid sinus syndrome

Fahed,

Isber,

Isber

2024

HeartRhythm Case Reports

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Incidence and predictors of prolonged hemodynamic depression after carotid artery stenting: Yet another benefit of statins?

Cited by 5 publications

References 43 publications

Incidence and risk factors for hypotension after carotid artery stenting: Systematic review and meta-analysis

Incidence and risk factors for hypotension after carotid artery stenting: Systematic review and meta-analysis

Effect of Statin on Radiographic and Clinical Outcomes of Intracranial Aneurysms Treated With Pipeline Embolization: A Propensity Score–Matched Analysis

Recurrent dizziness due to paroxysmal atrioventricular block following carotid artery stenting in a patient with a normal atrioventricular conduction and iatrogenic carotid sinus syndrome

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