Optimal blood pressure control for patients after thoracic endovascular aortic repair of type B aortic dissection

BackgroundGuidelines recommend tight systolic blood pressure (SBP) control for favorable outcomes of type B aortic dissection (BAD) but are still limited by the optimal cut-off value of SBP. The purpose of this study was to evaluate the optimal cut-off value of SBP in BAD patients after thoracic endovascular aortic repair (TEVAR).MethodsFrom January 2011 to April 2017, 269 consecutive patients with BAD after TEVAR were included in the study. All patients were followed up according to a strict follow-up protocol. Cox regression analysis was used to examine the association between SBP at discharge and 90-day aortic related adverse events (ARAE).ResultsAll 269 patients completed 90days of follow-up, and the unadjusted ARAE-free rates at 90-day was 95.11.3%. The cut-off value of SBP at discharge identified by receiver operator curve was 130mmHg for 90-day ARAE. In multivariable models, binary SBP at discharge was significant associated with 90-day ARAE (HR 3.780; 95% CI 1.236-11.556; p=0.020). Hybrid operation (OR 2.046; 95%CI 1.015-4.122; p=0.045) and insertion of 2 stents (OR 2.950; 95%CI 1.172-7.426; p=0.022) were demonstrated to be independently associated with poor SBP control (SBP>130mmHg) using Logistic analysis.ConclusionsThe optimal cut-off value of SBP at discharge was 130mmHg which can be used to predict short-term ARAE. Blood pressure in patients with hybrid operation and2 stents should be given more focus.