ORIGINAL ARTICLE  AORTIC DISEASE 

International Angiology 2021 February;40(1):60-6

DOI: 10.23736/S0392-9590.20.04433-8

Copyright © 2020 EDIZIONI MINERVA MEDICA

lingua: Inglese

Influence of TEVAR on blood pressure in subacute type B aortic dissection (TBAD) patients with refractory and non-refractory arterial hypertension

Marco V. USAI ✉, Nyityasmono T. NUGROHO, Alexander OBERHUBER, Giuseppe ASCIUTTO

Department of Vascular and Endovascular Surgery, University Hospital of Munich, Munich, Germany

BACKGROUND: Aim of this study was to compare the modifications of systemic blood pressure in patients with subacute type b aortic dissection (TBAD) and refractory (rHTN) and non-refractory arterial hypertension (N-rHTN) treated by thoracic endovascular aortic repair (TEVAR).
METHODS: Patients were divided into two groups, rHTN defined as blood pressure >140/90 mmHg with ≥5 antihypertensive drugs and patients with N-rHTN. Primary endpoint was the variation of mean systolic, diastolic and overall pressure (MSP, MDP and MAP) before and after antihypertensive treatment or TEVAR. Secondary endpoints were the 30-days mortality. Fifty-seven patients were included in this study.
RESULTS: Of the 44 Patients of the TEVAR group 21 were included in the N-rHTN group. The MSP before and after surgery for the N-rHTN group was 130 (±10 SD) and 111 (±22 SD) mmHg, P=0.01. In the rHTN group 164 (±17 SD) and 118 (±17 SD) mmHg (P=0.01). The reduction of MSP was greater in the rHTN group (P=0.01). The MAP before and after the TEVAR for the N-rHTN group was 90 (±10 SD) and 74 (±12 SD) mmHg (P=0.01), in the rHTN group 111 (±14 SD) and 70 (±9 SD) mmHg (P=0.01). The overall mortality rate group was 2.2% (1/44).
CONCLUSIONS: TEVAR for TBAD appears to positively affect blood pressure in patients with rHTN and N-rHTN.

KEY WORDS: Hypertension; Aorta; Dissection