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

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.