Hemodynamic Change During Carotid Artery Stenting of Elderly
Patients under General Anesthesia : Is there a Difference
Between Elderly and Non-elderly Patients ?

, Sung Hoon Cho; , Jung Hwan Lee; , Won Il Joo; , Hae Kwan Park, Kyung Jin Lee; , Hyoung Kyun Rha

Clinical Article

Journal of Korean Society of Geriatric Neurosurgery 2014;10(2):169-173.
Published online December 30, 2014.

Hemodynamic Change During Carotid Artery Stenting of Elderly Patients under General Anesthesia : Is there a Difference Between Elderly and Non-elderly Patients ?

Sung Hoon Cho , Jung Hwan Lee , Won Il Joo , Hae Kwan Park, Kyung Jin Lee , Hyoung Kyun Rha

Department of Neurosurgery, Catholic Neuroscience Center, St. Mary’s Hospital, The Catholic University of Korea, College of Medicine, Seoul, Korea

Abstract

Objective
The purpose of this study was to compare hemodynamic change to be happened during carotid artery stenting (CAS) between elderly and non-elderly patients.
Methods
A total of 34 consecutive patients with internal carotid artery stenosis (29 men; 5 women) who underwent CAS were included. All procedures were performed under general anesthesia. Patients were divided into two groups by age: nonelderly (<65 years) and elderly (≥65 years). The number of patients in each group was 11 and 23. We collected perioperative blood pressure and heart rate of each group and analyzed the data. Hemodynamic depression (HD) was defined as severe hypotension (systolic blood pressure < 90mmHg) and bradycardia (heart rate <50 beats/min).
Results
Mean systolic blood pressures (SBPs), diastolic blood pressures (DBPs), and heart rates (HRs) in post-stenting period were 87.4±10.8, 52.9±7 and 60.9±12.7 in the elderly group. In nonelderly patients, SBPs, DBPs and HRs were 98.6±15 (p=0.018), 61.9±9.9 (p=0.004) and 57±6.8 (p=0.251). Hemodynamic parameters between the elderly and the nonelderly group after finishing CAS procedure were similar to each other. HD was identified in 4 patients (17.4%) in the elderly group and one patient (9%) in the nonelderly group. The factor associated with HD was smoking (p=0.031).
Conclusion
Blood pressures during post-stenting period in elderly patients were lower than in non-elderly patients, and the incidence of HD was higher in elderly patient. HD was associated with smoking. Therefore, elderly patients with smoking history are needed more careful BP monitoring.

Key Words: Blood pressureㆍCarotid stenosisㆍElderly patientsㆍHemodynamicsㆍStents