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International Angiology 2020 Sep 22

DOI: 10.23736/S0392-9590.20.04433-8


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 Münster, Münster, 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 thoraric 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 = .01. In the rHTN group 164 (± 17 SD) and 118 (± 17 SD) mmHg (p = .01). The reduction of MSP was greater in the rHTN group (p = .01). The MAP before and after the TEVAR for the N-rHTN group was 90 (± 10 SD) and 74 (± 12 SD) mmHg (p =.01), in the rHTN group 111 (± 14 SD) and 70 (± 9 SD) mmHg (p = .01). The overall mortality rate group was 1.72.2% (1/4457).
CONCLUSIONS: TEVAR for TBAD appears to positively affect blood pressure in patients with rHTN and NrHTN.

KEY WORDS: Arterial hypertension; TEVAR; Aortic dissection

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