Article type
Abstract
"Background Hemodynamic depression(HD) was regular occurred in CAS when treating carotid stenosis and it could result in major adverse clinical event even death during or after CAS. However, the incidence and risk factors of HD were considerable difference between each primary articles. Objectives The purpose of this article was to clarify the incidence and risk factors for HD during or after CAS.
Methods we systematically searched PubMed, Embase, Cochrane Central Register of Controlled Trials, Web of Science that reported the incidence or the risk factors of HD during or after CAS from inception to July 14 2023 to identify the cohort or the case-controlled studies. We used modified version of the Newcastle-Ottawa scale to assess the risk bias of included case-controlled or cohort studies. The prevalence rates of HD from individual studies were pooled by using a random-effect analysis. For each reporting risk factors, We pooled ORs or RRs with a generic inverse variance-weighted, random effect model. We used randomized-effects model to summarize the evidence and we displayed the results by odds ratio with 95% confidence. After that, we made the funnel plots and egger’s test to assess the publication bias.
Results 51 studies assessed the incidence of HD and analyzed the risk factors of HD during or after CAS. Our meta-analysis has showed that the incidence of HD was 34.9%.Patients who had DM(OR=1.3, 95%CI:1.08 to 1,57,I2=40.8%), Stenosis to bifurcation < 10mm(OR=1.94,95%CI:1.03 to 3.68,I2=56.8%), stenosis involved bulb(OR=1.9,95%CI:1.07 to 3.38, I2=79.9), calcified plaque(OR= 2.06, 95%CI:1.32 to 3.22, I2=81.8%), eccentric plaque(OR=1.47, 95%CI:1.05 to 2.05,I2=44%), severe stenosis(OR=1.64, 95%CI:1.1 to 2.43, I2=4.3%), contralateral stenosis(OR=1.89,95%CI: 1.05 to 3.43,I2=0), open(OR= 1.5, 95%CI:1.04 to 2.15, I2=60.9) and bilateral stenting (OR=2.32,95%CI:1.56 to 3.44, I2=0) were associated with higher risk of HD.
Conclusions The incidence of HD is 34.9% and it can cause terrible MACE. DM, Stenosis to bifurcation < 10mm, stenosis involved bulb, calcified plaque, eccentric plaque, severe stenosis, contralateral stenosis, carotid open stents and bilateral carotid stenting are the risk factors of HD during or after CAS ."
Methods we systematically searched PubMed, Embase, Cochrane Central Register of Controlled Trials, Web of Science that reported the incidence or the risk factors of HD during or after CAS from inception to July 14 2023 to identify the cohort or the case-controlled studies. We used modified version of the Newcastle-Ottawa scale to assess the risk bias of included case-controlled or cohort studies. The prevalence rates of HD from individual studies were pooled by using a random-effect analysis. For each reporting risk factors, We pooled ORs or RRs with a generic inverse variance-weighted, random effect model. We used randomized-effects model to summarize the evidence and we displayed the results by odds ratio with 95% confidence. After that, we made the funnel plots and egger’s test to assess the publication bias.
Results 51 studies assessed the incidence of HD and analyzed the risk factors of HD during or after CAS. Our meta-analysis has showed that the incidence of HD was 34.9%.Patients who had DM(OR=1.3, 95%CI:1.08 to 1,57,I2=40.8%), Stenosis to bifurcation < 10mm(OR=1.94,95%CI:1.03 to 3.68,I2=56.8%), stenosis involved bulb(OR=1.9,95%CI:1.07 to 3.38, I2=79.9), calcified plaque(OR= 2.06, 95%CI:1.32 to 3.22, I2=81.8%), eccentric plaque(OR=1.47, 95%CI:1.05 to 2.05,I2=44%), severe stenosis(OR=1.64, 95%CI:1.1 to 2.43, I2=4.3%), contralateral stenosis(OR=1.89,95%CI: 1.05 to 3.43,I2=0), open(OR= 1.5, 95%CI:1.04 to 2.15, I2=60.9) and bilateral stenting (OR=2.32,95%CI:1.56 to 3.44, I2=0) were associated with higher risk of HD.
Conclusions The incidence of HD is 34.9% and it can cause terrible MACE. DM, Stenosis to bifurcation < 10mm, stenosis involved bulb, calcified plaque, eccentric plaque, severe stenosis, contralateral stenosis, carotid open stents and bilateral carotid stenting are the risk factors of HD during or after CAS ."