Neglected event in endovascular repair of aortic dissection

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.