颈动脉支架术后持续性血流动力学抑制的危险因素

目的 探讨颈动脉支架置入术（CAS）后持续性血流动力学抑制（PHD）的危险因素。方法 回顾性分析2017年3月至2020年10月CAS治疗的207例颈动脉狭窄的临床资料。结果 207例中，56例（25.9%）CAS后发生PHD，持续时间3～148 h，中位数13 h(9～20 h)。9例需要升压药维持收缩压≥90 mmHg,6例（2.8%）发生卒中。多因素logistic回归分析显示，无临床症状、狭窄部位与颈动脉分叉距离<10 mm、未服用他汀类药物是CAS后发生PHD的独立危险因素（P<0.05）。结论 CAS后PHD发生率较高。无症状性颈动脉狭窄、狭窄靠近颈动脉分叉的病人更容易发生PHD，服用他汀类药物有助于减少PHD。

Risk factors of persistent hemodynamic depression after carotid angioplasty stenting

Objective To explore the risk factors of persistent hemodynamic depression (PHD) after carotid angioplasty stenting (CAS). Methods The clinical data of Data from 207 patients with internal carotid stenosis who underwent CAS between March 2017 and October 2020 were retrospectively analyzed. Results Of these 207 patients, 56 (25.9%) patients suffered from PHD after CAS. The duration ranged from 3 hours to 148 hours, with a medium duration of 13 hours. Nine patients required vasopressors to maintain systolic blood pressure ≥90 mmHg, and 6 patients (2.8%) had a stroke. Multivariate logistic regression analysis showed that no clinical symptoms, the distance between stenosis site and carotid artery bifurcation <10 mm, and no statin use were independent risk factors for PHD after CAS (P<0.05). Conclusions The incidence of PHD is high after CAS. Patients with asymptomatic carotid stenosis and stenosis close to the bifurcation of the carotid artery are more likely to develop a PHD. Taking statins can help in reducing the risk of PHD.