Delayed occurrence of hypotension or bradycardia justifies continued monitoring of patients after carotid artery stenting
Research Activities, June 2009, No. 346
Patients who receive stents (mesh tubes that open up their carotid arteries to improve blood flow) can suffer from low heart rates (bradycardia) or low blood pressures (hypotension) after receiving their stents. Both conditions can indicate that the heart is not pumping enough blood to meet the body's demands. A new study finds that patients whose carotid arteries needed to be stented to improve cerebral blood flow were at risk for dipping heart and blood pressure rates within 12 hours of the procedure.
Twenty-eight percent of patients in the study experienced low blood pressure and 38 percent experienced low heart rates within 12 hours after receiving their stents. Patients who took medicine to control their high blood pressure or who never experienced a minor stroke but had narrowed arteries were at risk for having low heart rates. Older patients whose carotid arteries were especially narrow were likely to experience low blood pressure rates. However, 97 percent of patients appeared to be free from the threat of low blood pressure 6 to 12 hours after receiving their stents, and 91 percent were clear from low heart rates. The authors caution that though new onsets of low blood pressure or dropping heart rates are rare 6 to 12 hours after carotid stent insertion, patients should still be monitored for a minimum of 12 hours.
This study included 93 men and women who received carotid artery stents from December 2002 to January 2007. The study was funded in part by a grant from the Agency for Healthcare Research and Quality (HS16075) to the researchers at the Weill Medical College of Cornell University Center for Education and Research on Therapeutics (CERT). For more information on the CERTs program, visit http://www.ahrq.gov/clinic/certsovr.htm.
See "Predictors and timing of hypotension and bradycardia after carotid artery stenting," by P. Lavoie, John Rutledge, M.A.S., M. A. Dawoud, and others in the November-December 2008 American Journal of Neuroradiology 29(10), pp. 1942-1947.