Haemodynamic depression during carotid angioplasty and stenting

Haemodynamic depression is commonly defined as a change in arterial pressure (hypotension with systolic pressure values of less than 90 mmHg) and heart rate (bradycardia, heart rate of less than 60 beats per minute). Carotid angioplasty and stenting (CAS) can result in many complications, particularly in the perioperative period. Apart from the most serious complications, such as stroke and temporary ischaemic attack (TIA), as well as local complications (related to the puncture of the femoral artery), the researchers are especially interested in haemodynamic depression. It is closely related to the interventional treatment area. The region of the common carotid artery bifurcation and the initial section of the internal carotid artery are abundant in baroreceptors and mechanoreceptors. Various prophylactic measures were introduced to clinical practice due to possible complications, such as hypotension and perioperative bradycardia. They include preoperative fluid infusion, atropine administration, infusion of ‘pressor’ amines and provision of an intracardiac electrode for the time of the procedure.