Angioplasty and stenting of brachiocephalic artery stenosis can be complicated by ischemic stroke, local hematoma, thromboses, or dissection of access vessels. However, hemodynamic instability has not been reported as a complication of this treatment. We report the case of an 83-year-old man who developed hypotension and bradycardia after brachiocephalic artery stenting. He was admitted to our hospital with a right frontal infarct and severe brachiocephalic artery stenosis with cerebral hypoperfusion and subclavian steal syndrome. We performed brachiocephalic artery stenting with prophylactic atropine administration, during which he was hemodynamically stable. Post procedure, however, he developed hypotension and bradycardia requiring an atropine and dopamine drip. This hemodynamic instability resolved in approximately 12 hours and did not recur. He experienced no complications associated with this hemodynamic instability. This report provides evidence that hypotension and bradycardia can occur after brachiocephalic artery stenting.
Keywords: acute ischemic stroke; brachiocephalic artery stenosis; brachiocephalic artery stenting; bradycardia; evt: endovascular therapy; hypotension; stent placement.
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