Influence of stent type on hemodynamic depression after carotid artery stent placement

Diehm, N; Katzen, B.T.; Dick, F; Kovacs, M; Zemel, G; Powell, A; Samuels, S; Benenati, J.F. (2008). Influence of stent type on hemodynamic depression after carotid artery stent placement. Journal of vascular and interventional radiology, 19(1), pp. 23-30. New York, N.Y.: Elsevier 10.1016/j.jvir.2007.09.020

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PURPOSE: To assess the effect of stent type on hypotension and bradycardia after carotid artery stent placement. MATERIALS AND METHODS: A retrospective analysis on a prospectively maintained database was conducted in 256 patients (126 men; mean age, 71.8 years +/- 8.6; 194 de novo lesions) undergoing carotid artery stent placement between January 1996 and January 2007 by using self-expanding stents. Braided Elgiloy stents (Wallstents) were used in 44 of the 256 patients (17.2%) and slotted-tube nitinol stents were deployed in 212 (82.8%). Bivariate and multivariable logistic regression models were used to determine the influence of stent design on procedural and 24-hour hypotension and bradycardia. RESULTS: Procedural hemodynamic depression (HD) was encountered in 73 of the 256 patients (28.5%) due to hypotension in 24 (9.4%), bradycardia in 12 (4.7%), or both in 37 (14.5%) patients. Rates of procedural hypotension were 11.3% with nitinol stents and 0% with braided Elgiloy stents (P = .0188). Persistent postprocedural HD occurred in 91 of the 256 patients (35.5%) due to hypotension in 40 patients (15.6%), bradycardia in 23 (9.0%), or both in 28 (10.9%). Within a multivariable analysis adjusted for clinically relevant factors affecting rates of HD, the use of braided Elgiloy stents was associated with a decreased rate of procedural hypotension (odds ratio: 0.165; 95% confidence interval: 0.038, 0.721; P = .017). Procedural hypotension and bradycardia were not correlated to incidence of major adverse events but were associated with an increased duration of hospital stay (P = .0059 and P = .0335, respectively). CONCLUSIONS: Nitinol stents are associated with a higher risk of hypotension as compared to braided Elgiloy stents during carotid artery stent placement.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Angiology

UniBE Contributor:

Diehm, Nicolas Alexander

ISSN:

1051-0443

ISBN:

23-30

Publisher:

Elsevier

Language:

English

Submitter:

Factscience Import

Date Deposited:

04 Oct 2013 15:02

Last Modified:

17 Mar 2015 22:14

Publisher DOI:

10.1016/j.jvir.2007.09.020

Web of Science ID:

000252853200006

URI:

https://boris.unibe.ch/id/eprint/26872 (FactScience: 91602)

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