Hemodynamic changes between different anatomically designed stents after carotid stenting: a prospective multicenter study.

BACKGROUND: The aim of this study was to investigate differences in the dynamic changes and risk factors of hemodynamic depression (HD) between straight and tapered carotid stenting (SCS and TCS, respectively). METHODS: A total of 148 and 167 patients were included in TCS and SCS groups in this study, respectively. All clinical data were collected and analyzed for differences in HD and primary endpoint events at 12 months. RESULTS: The SCS procedure had a lower predilation rate and a higher incidence of intra- and postprocedure HD; furthermore, the decline in heart rate in the SCS procedure was higher in patients with intra- and postprocedure HD (P < 0.05). Right stenosis [odds ratio (OR) 1.67] and stent type (ev3) (OR 2.31) were confirmed as risk factors, and older age (> 70 years) was accompanied by a lower risk (OR 0.58; P < 0.05). The SCS procedure had a higher incidence of bradycardia and hypotension after 24 h and a longer duration of hypotension (P < 0.05). Stenosis (> 80%) (OR 1.68), the SCS procedure (OR 1.72), and alcohol intake (OR 2.38) were defined as risk factors. There was no difference in the complications or clinical endpoint events in either procedure, and the restenosis rate was lower in the TCS procedure (1.35% vs 5.42%). CONCLUSION: Our results reveal that TCS has a lower incidence of HD and that intra- and postprocedure HD have different manifestations and risk factors.