Objective To analyze the influencing factors and intervention strategies of postoperative hypotension in elderly carotid artery stenosis patients after stent implantation,and lay a foundation for the formulation and implementation of follow-up diagnosis and treatment measures.Methods A total of 114 carotid artery stenosis patients who underwent stent implantation from January 2020 to May 2023 at the Jiuquan Second People's Hospital were selected as the research objects,they were divided into a control group(74 cases,patients without hypotension)and an observation group(40 cases,patients with hypotension after surgery)according to whether they had hypotension after surgery.Univariate and multivariate logistic regression analysis were used to explore the risk factors of hypotension in elderly carotid artery stenosis patients after stent implantation.Results The results of univariate analysis showed that the proportion of patients with age≥70 years,bilateral stenting,presence of ulcer plaque,history of hypotension and severe stenosis of the observation group were higher than those of the control group,the differences were statistically significant (P＜0.05).Multivariate logistic analysis showed that age≥70 years(β=0.141,OR=1.513,95%CI:1.186-1.929),bilateral stent placement(β=0.422,OR=1.525,95%CI:1.121-2.074),presence of ulcerated plaque (β=0.387,OR=1.473,95%CI:1.108-1.957),history of hypotension (β=0.407,OR=1.502,95%CI:1.039-2.172),severe stenosis (β=0.415,OR=1.514,95%CI:1.100-2.084)were all risk factors for postoperative hypotension in elderly carotid artery stenosis patients after stent implantation(P＜0.05).Conclusion Age≥70 years,bilateral stenting,presence of ulcer plaque,history of hypotension,and severe stenosis were independent risk factors for postoperative hypotension in elderly carotid artery stenosis patients,follow-up interventions based on these results can reduce the risk of postoperative hypotension in elderly carotid artery stenosis patients.