Study of agreement of aortic, radial and femoral blood pressures during aortic endografting

Abstract

Purpose: To estimate the agreement between radial or femoral, and ascending aortic invasive blood pressure values.

Patients and methods: Prospective study on 32 patients who underwent an aortic endografting under general anesthesia. After deploying the prosthesis under controlled hypotension, a catheter was introduced in the aorta to measure the staged systolic (SAP), diastolic (DAP) and mean (MAP) arterial pressures, in particular at the level of ascending aorta and femoral artery.

Results: No differences were observed between SAP, DAP or MAP measured in the aorta versus femoral or radial arteries. A better agreement was observed between the aortic and femoral MAP (bias of 1mmHg, limits of agreement between: -8.8mmHg and +10.8mmHg) than between the aortic and the radial MAP (bias of 1.7mmHg, limits of agreement between: -14.1mmHg and +17.5mmHg). The comparison between radial and femoral MAP was not satisfying (bias of -4.7mmHg and limits of agreement between -19.1mmHg and +9.7mmHg).

Conclusion: The femoral MAP is more accurate to predict value of the aortic MAP than the radial MAP in a hypotensive setting. The clinician should be aware of these discrepancies in conditions of hemodynamic impairment to optimize the treatment.

Keywords: Aorte ascendante; Aortic endografting; Artère fémorale; Artère radiale; Ascending aorta; Endoprothèse aortique; Invasive arterial pressure monitoring; Limites de concordance; Limits of agreement; Monitorage de pression artérielle invasive; Radial and femoral arteries.