Morishita Masahiro, Yamazaki Takaaki, Moriwaki Hiroshi, Senoo Makoto, Nishiya Mikio
Department of Neurosurgery, Hakodate Neurosurgical Hospital, Hokkaido, JPN.
Cureus. 2024 Dec 6;16(12):e75249. doi: 10.7759/cureus.75249. eCollection 2024 Dec.
Angioplasty and stenting of brachiocephalic artery stenosis can be complicated by ischemic stroke, local hematoma, thromboses, or dissection of access vessels. However, hemodynamic instability has not been reported as a complication of this treatment. We report the case of an 83-year-old man who developed hypotension and bradycardia after brachiocephalic artery stenting. He was admitted to our hospital with a right frontal infarct and severe brachiocephalic artery stenosis with cerebral hypoperfusion and subclavian steal syndrome. We performed brachiocephalic artery stenting with prophylactic atropine administration, during which he was hemodynamically stable. Post procedure, however, he developed hypotension and bradycardia requiring an atropine and dopamine drip. This hemodynamic instability resolved in approximately 12 hours and did not recur. He experienced no complications associated with this hemodynamic instability. This report provides evidence that hypotension and bradycardia can occur after brachiocephalic artery stenting.
头臂动脉狭窄的血管成形术和支架置入术可能会并发缺血性中风、局部血肿、血栓形成或穿刺血管夹层。然而，血流动力学不稳定尚未被报道为这种治疗的并发症。我们报告了一例83岁男性在头臂动脉支架置入术后出现低血压和心动过缓的病例。他因右额叶梗死、严重头臂动脉狭窄伴脑灌注不足和锁骨下窃血综合征入院。我们在预防性给予阿托品的情况下进行了头臂动脉支架置入术，术中他的血流动力学稳定。然而，术后他出现了低血压和心动过缓，需要静脉滴注阿托品和多巴胺。这种血流动力学不稳定在大约12小时后缓解，未再复发。他没有出现与这种血流动力学不稳定相关的并发症。本报告提供了证据表明头臂动脉支架置入术后可能会发生低血压和心动过缓。
