Repeated Cardiac Arrest Following Emergency Carotid Artery Stenting.- A Case Report.

Abstract Background: Due to carotid sinus response, blood pressure reduction and bradycardia during and after carotid stent implantation was reported frequently, in contrast, repeated cardiac arrest is rare but fatal unless the heart can be started quickly. Case introduction: A 61-year-old male presented with severe left hemiplegia, aphasia, central facial palsy and gaze. Emergency surgery under general anesthesia was finally scheduled in view of possible severe cerebral arterial stenosis. The patient underwent ipsilateral ICA stenting after balloon dilatation and was transferred to intensive care unit(ICU). His heart rate tended to decrease sharply and then cardiac arrest was noted on electrocardiograph(ECG) monitor. Emergency cardiopulmonary resuscitation(CPR) was started and repeated three times due to persistent symptoms. Coronary angiography was postponed for 15 days until neurological recovery. Multivessel disease with severe stenosis one of them was confirmed and percutaneous coronary intervention (PCI) was performed. The patient was discharged on the 20th day of admission with only slight neurological deficits. Conclusion: We tend to attribute the causes of repeated cardiac arrest in this case to carotid sinus response induced by stenting and serious coronary stenosis.