Relationship of Inter-Arm Systolic Blood Pressure Difference with Subclavian Artery Stenosis and Vertebral Artery Stenosis in Patients Undergoing Carotid Endarterectomy

Abstract

Introduction: The aim of this study was to examine the association of inter-arm systolic blood pressure difference (IASBPD) with carotid artery stenosis, subclavian artery stenosis and vertebral artery stenosis in patients who underwent carotid endarterectomy. Methods: A total of 141 patients (29 females, 112 males; mean age 71.2 +/- 10.4 years; range 47 to 92 years) who underwent carotid endarterectomy between September 2010 and December 2017 were retrospectively evaluated. We classified patients into four groups according to the IASBPD. 10 mmHg, >= 10 mm Hg, >= 20 mmHg and >= 30 mmHg. The stenosis of both subclavian and ertebral arteries was considered as >= 50%. Results: Of the 141 patients, 44 (31.2%) had >= 10 mmHg, 29 (20.5%) had >= 20 mmHg and 4 (2.8%) had >= 30 mmHg of IASBPD. 26 patients (18.4%) were diagnosed with significant subclavian artery stenosis and 18 (69.2%) of them had more than 20 mmHg of IASBPD. Of the 29 patients with IASBPD = 20 mmHg, 19 patients (65.5%) had a significant subclavian artery stenosis. We found a significant correlation between preoperative symptoms and subclavian artery stenosis (P= 0.018) and overall perioperative stroke was seen more frequently in patients with subclavian artery stenosis (P= 0.041). A significant positive correlation was observed between vertebral artery stenosis and subclavian artery stenosis (P= 0.01). Conclusion: Patients who were diagnosed with both subclavian artery stenosis and IASBPD (>= 20 mmHg) had a higher risk of postoperative stroke and death, had higher total cholesterol, LDL-C, blood creatinine level, and were more symptomatic.