Pre-operative Antihypertension Strategies-Carotid Artery Stenting

Launched by WEST CHINA HOSPITAL · Jun 7, 2023

Keywords

ClinConnect Summary

This clinical trial is investigating how different blood pressure medications can affect patients undergoing a procedure called carotid artery stenting (CAS), which is used to prevent strokes. The main goal is to see if certain antihypertensive drugs can help reduce the risk of low blood pressure after the stenting procedure, which can lead to serious complications and longer hospital stays. The researchers are particularly interested in understanding how these medications impact patients who already have high blood pressure.

To participate in the trial, individuals must be at least 18 years old and have a history of mini-strokes or strokes in the past six months, along with significant narrowing of the carotid artery caused by plaque buildup. They should also have high blood pressure that requires treatment. However, there are specific conditions that would exclude someone from joining, such as recent surgeries on the carotid artery, certain medical issues, or allergies to some common medications. If eligible, participants can expect to receive careful monitoring during the study to assess how well the different medications work in preventing low blood pressure after their stenting procedure.

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • age ≥ 18
• • have a history of TIA or nondisabling ischemic stroke within the past 6 months (symptomatic) with ipsilateral initial part of EICA stenosis ≥ 50 % or asymptomatic with initial part of EICA stenosis ≥ 70%, and the cause of stenosis was atherosclerosis
• • have hypertension requiring hypertensives
• • modified Rankin scale (mRS) before stenting \< 3
• Exclusion Criteria:
• • with ipsilateral tandem stenosis
• • with history of operation in contralateral carotid artery, like stenting, endarterectomy and bypass.
• • requiring operation in contralateral carotid artery in the same admission.
• • requiring general anesthesia in the same operation (stenting)
• • with contraindication to carotid stenting, such as Inability to tolerate surgery due to organ dysfunction, cerebral aneurism, cerebral hemorrhage in 3 months, myocardial infraction or large-area cerebral infraction within 2 weeks, extreme tortuosity of the vessel
• • allergic to Calcium channel blockers, angiotensin receptor blockers or hydrochlorothiazide
• • pregnancy
• • with concomitant medication as following: Azole antifungals, macrolides antibiotics, cardiac calcium channel blockers, Rifampicin, sildenafil, simvastatin, immunosuppressants, antidepressants, valproic acid, cimetidine, aliskiren, NSAIDs, protease inhibitors (ritonavir) and drugs that affect potassium in the blood
• • with hepatic insufficiency, renal insufficiency, kidney transplantation, diabetic nephropathy, biliary obstructive disease, or the presence of end-stage disease affecting clinical prognosis assessment (such as end-stage cancer, end-stage heart disease, liver failure, renal failure, pulmonary failure)
• • with depression, schizophrenia, bipolar disorder, epilepsy, tuberculosis, AIDS, primary hyperaldosteronism, hyperkalemia, hypercalcemia, hyperuricemia, gout
• • participating other trails which would affect the evaluation of outcomes
• • with reserpine and clonidine intake within 1 week