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Branch vessel complications are increased in aortic dissection patients with renal insufficiency.

Publication ,  Journal Article
Beckman, JA; Mehta, RH; Isselbacher, EM; Bossone, E; Cooper, JV; Smith, DE; Fang, J; Sechtem, U; Pape, LA; Myrmel, T; Nienaber, CA; Eagle, KA ...
Published in: Vasc Med
November 2004

Morbidity and mortality from aortic dissection remain high despite advances in diagnosis and treatment. Simple markers to identify patients at high risk for non-aortic complications of dissection are lacking. We investigated the effect of renal insufficiency on the presentation, complications, and outcome of patients with acute aortic dissection. We evaluated 638 patients with type A and 365 patients with type B aortic dissection enrolled in the International Registry of Acute Aortic Dissection (IRAD) between January 1996 and December 2000. Chi-squared and Student's ttesting were performed to identify the effect of renal insufficiency on patient presentation, management, and outcome. Patients with renal insufficiency more often required nitroprusside for blood pressure control (type A: 40.7% vs 31.1%, p = 0.049; type B: 66.7% vs 37.3, p = 0.0001) and had a greater risk of mesenteric ischemia (type A: 10.7% vs 1.4%, p < 0.0001; type B: 17.7% vs 3.0%, p < 0.0001). In conclusion, aortic dissection patients with renal insufficiency are at increased risk for drug-resistant hypertension and aortic branch vessel compromise. Routine measurement of serum creatinine provides a readily accessible clinical marker for important complications. Upon recognition, renal impairment indicates a need for close monitoring, aggressive blood pressure control, and evaluation of aortic branch vessel circulations.

Duke Scholars

Published In

Vasc Med

DOI

ISSN

1358-863X

Publication Date

November 2004

Volume

9

Issue

4

Start / End Page

267 / 270

Location

England

Related Subject Headings

  • Systole
  • Renal Insufficiency
  • Registries
  • Nitroprusside
  • Middle Aged
  • Male
  • Humans
  • Female
  • Diastole
  • Creatinine
 

Citation

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Beckman, J. A., Mehta, R. H., Isselbacher, E. M., Bossone, E., Cooper, J. V., Smith, D. E., … O’Gara, P. T. (2004). Branch vessel complications are increased in aortic dissection patients with renal insufficiency. Vasc Med, 9(4), 267–270. https://doi.org/10.1191/1358863x04vm561oa
Beckman, Joshua A., Rajendra H. Mehta, Eric M. Isselbacher, Eduardo Bossone, Jeanna V. Cooper, Dean E. Smith, Jianming Fang, et al. “Branch vessel complications are increased in aortic dissection patients with renal insufficiency.Vasc Med 9, no. 4 (November 2004): 267–70. https://doi.org/10.1191/1358863x04vm561oa.
Beckman JA, Mehta RH, Isselbacher EM, Bossone E, Cooper JV, Smith DE, et al. Branch vessel complications are increased in aortic dissection patients with renal insufficiency. Vasc Med. 2004 Nov;9(4):267–70.
Beckman, Joshua A., et al. “Branch vessel complications are increased in aortic dissection patients with renal insufficiency.Vasc Med, vol. 9, no. 4, Nov. 2004, pp. 267–70. Pubmed, doi:10.1191/1358863x04vm561oa.
Beckman JA, Mehta RH, Isselbacher EM, Bossone E, Cooper JV, Smith DE, Fang J, Sechtem U, Pape LA, Myrmel T, Nienaber CA, Eagle KA, O’Gara PT. Branch vessel complications are increased in aortic dissection patients with renal insufficiency. Vasc Med. 2004 Nov;9(4):267–270.
Journal cover image

Published In

Vasc Med

DOI

ISSN

1358-863X

Publication Date

November 2004

Volume

9

Issue

4

Start / End Page

267 / 270

Location

England

Related Subject Headings

  • Systole
  • Renal Insufficiency
  • Registries
  • Nitroprusside
  • Middle Aged
  • Male
  • Humans
  • Female
  • Diastole
  • Creatinine