Changes in Perioperative Systolic Blood Pressure in Percutaneous Renal Mass Cryoablation.

Abstract

To analyze changes in systolic blood pressure (SBP) in the perioperative period of percutaneous renal mass cryoablation and risk factors. This retrospective study included 54 patients who underwent percutaneous renal cryoablation. SBP before ablation (pre-Tx), during ablation (intra-Tx), immediately after ablation (post-Tx), and before discharge (discharge) were measured using a BP cuff. The highest SBP during cryoablation was regarded as SBP at intra-Tx. Antihypertensive agents were administrated when SBP was 160mmHg or greater during cryoablation. Relationship between SBP at pre-Tx, pain degree, tumor size, cryoprobe number, or endophytic extension of the radiographic ice-ball, and SBP elevation or administration of antihypertensive agents was investigated. Mean SBP elevation from pre-Tx to intra-Tx was 22.9±18.0mmHg (range -6-78mmHg). SBP of intra-Tx was significantly higher than that of the other periods (p<.001), while SBP of post-Tx or discharge was similar with that of pre-Tx (p>.05). Tumor size (r=.324; p=.016), cryoprobe number (r=.300; p=.027), and endophytic extension (r=.348; p=.009) were correlated with SBP elevation, while SBP at pre-Tx or pain degree were not (p>.05). Antihypertensive agents were administrated for 24 patients (44.4%). In multivariate analysis, SBP at pre-Tx and endophytic ablation was associated with administration of antihypertensive agents during cryoablation (p<.05). SBP elevation may occur during percutaneous renal mass cryoablation, but be improved before discharge. Endophytic extension of the radiographic ice-ball may be associated with significant BP elevation during ablation.