颈动脉支架植入术中低血流动力学紊乱相关危险因素

目的分析颈动脉支架植入(CAS)术中低血流动力学紊乱(HD)的危险因素。方法回顾性分析121例接受CAS患者,根据CAS术中血压和心率变化评估有无HD;以单因素及多因素logistic回归分析筛选CAS中发生HD的危险因素。结果共42例发生HD(HD组),其中27例见于球囊扩张时,14例见于植入支架时,1例见于以封堵器封堵血管时;79例未见HD(非HD组)。单因素分析显示,组间患者年龄、颈动脉狭窄程度和部位(有无累及球部或分叉部)、血管斑块性质及球囊后扩张差异均有统计学意义(P均<0.05);多元logistic回归结果显示,年龄、狭窄部位、血管斑块性质及球囊后扩张均为HD的独立危险因素(P均<0.05)。结论CAS术中发生HD与患者年龄、颈动脉狭窄部位、血管斑块性质及有无球囊后扩张有关。

Risk factors of hemodynamic depression during carotid artery stenting

Objective To analyze the risk factors of hemodynamic depression (HD) during carotid artery stenting (CAS). Methods Data of 121 patients with carotid artery stenosis who underwent CAS were retrospectively analyzed. HD was evaluated according to the changes of blood pressure and heart rate during CAS. Univariate and multivariate logistic regression analysis were used to screen the risk factors for HD during CAS. Results Among 121 patients, HD occurred in 42 cases (HD group), including 27 developed HD during balloon dilatation, 14 during stents implantation and 1 case during vascular occlusion with vascular occluder, whereas 79 cases were found without HD (non HG group). Univariate analysis showed that there were statistical differences of age, degree of carotid artery stenosis, stenosis site of carotid artery (whether involved bulb or bifurcation), characteristics of cervical vascular plaque and posterior balloon dilatation between groups (all P<0.05). Multivariate logistic regression analysis showed that age, stenosis site, characteristics of carotid plaque and post balloon dilatation were all independent risk factors for HD during CAS (all P<0.05). Conclusion Patients'' age, stenosis site of carotid artery, characteristics of carotid plaque and post balloon dilatation were associated with HD during CAS.