Department of Neurology, Jinling Hospital, Second Military Medical University, 305 East Zhongshan Road, Nanjing 210002, China.
J Clin Neurosci. 2011 Oct;18(10):1325-8. doi: 10.1016/j.jocn.2011.01.030. Epub 2011 Jul 23.
We aimed to investigate the risk factors for haemodynamic depression (HD) during and after carotid artery stenting (CAS). A total of 251 patients with CAS, enrolled between June 2004 and December 2008, were divided into two groups according to periprocedure observations: (i) a group with HD (systolic blood pressure<90 mm Hg and heart beat rate<50/ beats per minute); and (ii) a group without (non-HD). The risk factors for HD were analysed by univariate analysis and a logistic regression model. The univariate analysis of variance showed that the following factors were significantly associated with HD in patients with CAS: severe calcified plaque, stenosis greater than 70%, distance from the carotid bifurcation to the maximum stenotic lesion of <10mm, balloon dilation lasting more than 5 s with a pressure of more than 8 atmospheres (atm), multiple balloon dilations, balloon length, balloon diameter, and bilateral stenting. The results of the logistic regression model analysis showed that the following were independent risk factors for HD during and after CAS: the degree of stenosis, severe calcified plaque, bilateral stenting and a balloon dilation pressure of >8 atm. We concluded that patients with stenosis>70%, severe calcified plaque, bilateral stenting and a balloon dilation pressure>8 atm may be more likely to develop HD during and after CAS.
我们旨在探讨颈动脉支架置入术（CAS）期间和之后发生血流动力学压低（HD）的危险因素。共纳入 251 例于 2004 年 6 月至 2008 年 12 月接受 CAS 的患者，根据围手术期观察结果将其分为两组：（i）发生 HD 组（收缩压<90mmHg 和心率<50 次/分钟）；（ii）未发生 HD 组（非 HD 组）。采用单因素分析和逻辑回归模型分析 HD 的危险因素。单因素方差分析显示，以下因素与 CAS 患者的 HD 显著相关：严重钙化斑块、狭窄程度>70%、颈动脉分叉至最大狭窄病变的距离<10mm、压力>8 个大气压（atm）持续时间>5s 的球囊扩张、多次球囊扩张、球囊长度、球囊直径和双侧支架置入。逻辑回归模型分析结果显示，以下是 CAS 期间和之后发生 HD 的独立危险因素：狭窄程度、严重钙化斑块、双侧支架置入和球囊扩张压力>8atm。我们得出结论，狭窄程度>70%、严重钙化斑块、双侧支架置入和球囊扩张压力>8atm 的患者在 CAS 期间和之后发生 HD 的可能性更大。
