A neglected event in endovascular repair of aortic dissection: acute blood pressure variability during aortic angiography

Main Article Content

Wen Tian
Zhijun Mei
Jian Zhou
Qingsheng Lu
Zaiping Jing

Abstract

[Purpose]To investigate acute blood pressure change during aortic angiography in aortic dissection endovascular repair, and analyse the potential risk of this incident.
[Method]24 patients with aortic dissection underwent endovascular repair in department of vascular surgery of Changhai hospital between May 2016 and July 2016 were enrolled in this research. Patients were divided into two groups: patients underwent general anesthesia and patients underwent lumbar anesthesia. Blood pressure was monitored by intro-artery catheter. Blood pressure readings were recorded every 10 seconds during the procedure of angiography. Outcome of these patients were observed in hospital.
[Result] All patients received endovascular aortic repair, with 19 underwent lumbar anesthesia and 5 underwent general anesthesia. Patients underwent lumbar anesthesia presented temporary blood pressure decrease with average of -11.2±13.4mmHg, while patients underwent general anesthesia presented temporary blood pressure elevation with average of 4.2±6.3mmHg. The Maximum time interval were 26.7±12.7s vs25.8±15.8s, and difference in blood pressure between pre- and post-angiography were 1.53±4.4mmHg vs. 4.6±3.4mmHg, both without significance (P>0.05).
[Conclusion] Angiography is an effective factor influencing blood pressure during TEVAR, it’s a potential “trigger” of intra-operative cardiovascular events. Blood pressure should be kept on proper level to avoid cardiovascular events induced by blood pressure variability with angiography. Angiography with General anesthesia has less influence on blood pressure than with lumbar anesthesia.

Downloads

Download data is not yet available.

Article Details

How to Cite
Tian, W., Mei, Z., Zhou, J., Lu, Q., & Jing, Z. (2018). A neglected event in endovascular repair of aortic dissection: acute blood pressure variability during aortic angiography. International Journal for Innovation Education and Research, 6(8), 235-240. https://doi.org/10.31686/ijier.Vol6.Iss8.1139
Section
Articles
Author Biographies

Zhijun Mei, Changhai Hospital

Vascular Surgery Department

Jian Zhou, Changhai Hospital

Vascular Surgery Department

Qingsheng Lu, Changhai Hospital

Vascular Surgery Department

Zaiping Jing, Changhai Hospital

Vascular Surgery Department

References

1. Krzych LJ, Krejca M, Bis J, Wasiak M, Bialek K, Szurlej D, Bochenek A. Perioperative blood pressure variability in patients undergoing coronary artery bypass grafting: Its magnitude and determinants. Blood Press Monit. 2011;16:129-133
2. Rothwell PM. Limitations of the usual blood-pressure hypothesis and importance of variability, instability, and episodic hypertension. Lancet. 2010;375:938-948
3. Rothwell PM. Does blood pressure variability modulate cardiovascular risk? Curr Hypertens Rep. 2011;13:177-186
4. Rothwell PM, Howard SC, Dolan E, O'Brien E, Dobson JE, Dahlof B, Poulter NR, Sever PS. Effects of beta blockers and calcium-channel blockers on within-individual variability in blood pressure and risk of stroke. Lancet Neurol. 2010;9:469-480
5. Rothwell PM, Howard SC, Dolan E, O'Brien E, Dobson JE, Dahlof B, Sever PS, Poulter NR. Prognostic significance of visit-to-visit variability, maximum systolic blood pressure, and episodic hypertension. Lancet. 2010;375:895-905
6. Pringle E, Phillips C, Thijs L, Davidson C, Staessen JA, de Leeuw PW, Jaaskivi M, Nachev C, Parati G, O'Brien ET, Tuomilehto J, Webster J, Bulpitt CJ, Fagard RH. Systolic blood pressure variability as a risk factor for stroke and cardiovascular mortality in the elderly hypertensive population. J Hypertens. 2003;21:2251-2257
7. Dawson SL, Manktelow BN, Robinson TG, Panerai RB, Potter JF. Which parameters of beat-to-beat blood pressure and variability best predict early outcome after acute ischemic stroke? Stroke. 2000;31:463-468
8. Aronson S, Dyke CM, Levy JH, Cheung AT, Lumb PD, Avery EG, Hu MY, Newman MF. Does perioperative systolic blood pressure variability predict mortality after cardiac surgery? An exploratory analysis of the eclipse trials. Anesth Analg. 2011
9. Aronson S, Stafford-Smith M, Phillips-Bute B, Shaw A, Gaca J, Newman M. Intraoperative systolic blood pressure variability predicts 30-day mortality in aortocoronary bypass surgery patients. Anesthesiology. 2010;113:305-312