MISC 10. Improved Perfusion As Predictor of Successful Perioperative Blood Pressure Control

The aim of this study was to search for predictors of successful perioperative blood pressure control in patients receiving percutaneous transluminal renal angioplasty and to evaluate whether improved perfusion would be a favorable predictor. We include 24 patients who were diagnosed with renal artery stenosis and received endovascular treatment in our center. Flat-panel detector parenchymal blood volume imaging was performed in all those patients, and perfusion information was collected. These statistics along with other data were used in constructing binary logistic regression and calculating odds ratio. Perioperative blood pressure was significantly reduced (pre/post systolic blood pressure, 137.67 ± 16.39/129.00 ± 12.01 mm Hg [P = .005]; pre/post diastolic blood pressure, 78.08 ± 12.40/74.17 ± 11.72 mm Hg [P = .04]; Table I). The odds ratio of change in parenchymal blood volume per 10 HU was 1.2210 (95% confidence interval, 1.034-1.476; P = .06). The odds ratio of systolic hypertension before operation was 10.533 (95% confidence interval, 0.992-107.306; P = .047; Table II). Improved perfusion after endovascular treatment is a predictor of successful blood pressure reduction during operative periods. Patients with systolic hypertension even under medical therapy respond well to endovascular treatment and may benefit more from it.Table ICharacteristics of the 24 patients before and after percutaneous transluminal renal angioplasty (PTRA)Before PTRAAfter PTRAP valueSystolic blood pressure, mm Hg137.67 ± 16.39129.00 ± 12.01.005Diastolic blood pressure, mm Hg78.08 ± 12.4074.17 ± 11.72.040MBP, mm Hg97.94 ± 12.2692.44 ± 10.72.011PBV CM, HU/g295.52 ± 104.47352.38 ± 87.13.004CM, Contrast medium; MBP, mean blood pressure; PBV, parenchymal blood volume. Open table in a new tab Table IIBinary logistic regression model for protective factors associated with successful blood pressure reduction after percutaneous transluminal renal angioplasty (PTRA) during perioperative periodVariables in modelOdds ratioa (95% CI)P valueΔPBV CM, 10 HU/g1.210 (1.034-1.476).06Systolic blood pressure before PTRA10.533 (0.992-107.306).047CI, Confidence interval; CM, contrast medium; PBV, parenchymal blood volume.Systolic blood pressure: normal (<140 mm Hg) = 0; high (≥140 mm Hg) = 1.aOdds ratios were derived from binary logistic regression analysis. Types of antihypertensive drug before PTRA were adjusted in the binary logistic regression analysis. Open table in a new tab