Korean Circulation Journal

  • 제48권3호
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  • Pages.217-226
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  • 2018
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  • 1738-5520(pISSN)
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  • 1738-5555(eISSN)
대한심장학회 (The Korean Society of Cardiology)
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Low Common Carotid Artery Systolic Occlusion Pressure and Symptomatic Carotid Artery Stenosis Are Associated with Development of Neurologic Intolerance during Proximal Protected Carotid Artery Stenting

  • Kwon, Hee-Jin (Division of Cardiology, Department of Internal Medicine, Chungnam National University Hospital, Chungnam National University School of Medicine) ;
  • Park, Jae-Hyeong (Division of Cardiology, Department of Internal Medicine, Chungnam National University Hospital, Chungnam National University School of Medicine) ;
  • Lee, Jae-Hwan (Division of Cardiology, Department of Internal Medicine, Chungnam National University Hospital, Chungnam National University School of Medicine) ;
  • Jeong, Hye Seon (Department of Neurology, Chungnam National University Hospital, Chungnam National University School of Medicine) ;
  • Song, Hee-Jung (Department of Neurology, Chungnam National University Hospital, Chungnam National University School of Medicine) ;
  • Kim, Jei (Department of Neurology, Chungnam National University Hospital, Chungnam National University School of Medicine) ;
  • Kim, Mijoo (Division of Cardiology, Department of Internal Medicine, Chungnam National University Hospital, Chungnam National University School of Medicine) ;
  • Kwon, In-Sun (Clinical Trial Center, Chungnam National University Hospital, Chungnam National University School of Medicine) ;
  • Seong, In-Whan (Division of Cardiology, Department of Internal Medicine, Chungnam National University Hospital, Chungnam National University School of Medicine)
  • 투고 : 2017.09.17
  • 심사 : 2017.12.06
  • 발행 : 2018.03.19
⟨ 이전 논문 다음 논문 ⟩

초록

Background and Objectives: Neurologic intolerance (NI) is defined as the occurrence of neurological symptoms during carotid artery stenting (CAS). Because NI is inevitable problem, it may be helpful to anticipate its occurrence. So, we studied factors associated with NI during proximal protected CAS. Methods: We retrospectively analyzed all consecutive patients underwent proximal protected CAS from August 2012 to January 2017. Results: We included total 123 patients (109 males, $72{\pm}8$ years old). The total procedure time was $43{\pm}12minutes$, and mean occlusion time was $4.8{\pm}1.2minutes$. We divided CAS patients into 2 groups according to presence of NI; neurologic tolerance (NT; n=74, 60%) and NI (n=49, 40%) groups. After the univariate analysis, symptomatic carotid artery stenosis (p=0.003), absence of anterior communicating artery (p=0.015) and low common carotid artery occlusion pressure (CCAOP, p<0.001) were associated with NI. After the multivariate analysis, NI was significantly associated with symptomatic carotid artery stenosis (odds ratio [OR], 5.549; p=0.014) and systolic $CCAOP{\leq}42mmHg$ (OR, 6.461; p<0.001). In NI group, 43 patients (88%) recovered right after the balloon deflation and 2 patients were normalized within 2 hours. However, 1 had major stroke and 3 had minor strokes in 4 patients with persistent $NI{\geq}24hours$. Conclusion: About 40% showed NI during the CAS. Most of them (88%, 43 of 49 patients) recovered after the balloon deflation, but stroke incidence was significantly higher in NI group. Symptomatic carotid artery stenosis and systolic $CCAOP{\leq}42mmHg$ were significantly associated with the development of NI during proximal protected CAS.

키워드

참고문헌

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피인용 문헌

  1. Risk factors for new ischemic cerebral lesions after carotid artery stenting: A systematic review and meta-analysis vol.77, pp.None, 2018, https://doi.org/10.1016/j.avsg.2021.05.031