Background: Hypotension and bradycardia are known to occur frequently in carotid artery stenting (CAS), which may lead to postprocedural complications. The purpose of this retrospective study was to assess the efficacy of cilostazol, a phosphodiesterase 3 inhibitor, for preventing bradycardia and hypotension in the periprocedural period.
Methods: The study population comprised 53 patients (54 lesions) with carotid artery stenosis who underwent CAS at our institution between 2004 and 2008. The patients were categorized by the use (group C, n = 26) or nonuse of cilostazol (group N, n = 28). The incidences of intraprocedural and postprocedural hypotension and bradycardia in each group were statistically assessed.
Results: Intraprocedural hypotension and bradycardia occurred in 9 cases (34.6%) and 4 cases (15.3%) in group C and in 5 cases (17.9%) and 15 cases (53.6%) in group N, respectively. Postprocedural hypotension and bradycardia occurred in 4 cases (15.4%) and 0 cases in group C and in 1 case (3.6%) and 3 cases (10.7%) in group N, respectively. The incidence of intraprocedural bradycardia (IBc) was significantly lower in group C (P = .0035). Logistic regression analysis revealed that the use of cilostazol decreased the risk of IBc 99.5% (odds ratio [OR] = .01, 95% confidence interval [CI]: 5.46 × 10(-6) to .04, P = .001) and distance from carotid bifurcation to maximum stenotic lesion was independently associated with IBc (OR = .46, 95% CI: .29-.74, P = .001).
Conclusion: Use of cilostazol was associated with a lower incidence of IBc. Cilostazol may be a useful drug for the prevention of this complication.
Keywords: Bradycardia; carotid artery stenting; cilostazol; hypotension.
Copyright © 2014 National Stroke Association. Published by Elsevier Inc. All rights reserved.