Determinants of Changes in Arterial Stiffness after Thoracic Endovascular Aortic Repair

Background: Aortic stent grafting can cause aortic stiffening and increase pulse wave velocity (PWV), which can potentially affect long-term cardiovascular outcomes. The aim of this study was to clarify the factors contributing to increases in PWV after thoracic endovascular aortic repair (TEVAR).Methods: We included 64 patients with thoracic aortic pathology (51 men; mean age, 73 years) who underwent elective TEVAR, in this study. TEVAR was performed for degenerative aortic aneurysm (n = 43) or aortic dissection (n = 21), and the treatment length was 175 +/- 52 mm. Brachial-ankle PWV (baPWV) was obtained before and 1 week after TEVAR. Univariable and multivariable logistic regression analyses were used to determine the predictors of increases in baPWV of >= 100 cm/sec after TEVAR.Results: baPWV increased from 1,851 +/- 392 cm/sec to 2,047 +/- 479 cm/sec, and the change in baPWV (DbaPWV) was 195 +/- 339 cm/sec (95% confidence interval, 111-280). Thirty-seven patients (58%) had Delta baPWV > 100 cm/sec after TEVAR. In the multivariable analysis, in addition to Dheart rate and Dsystolic blood pressure, age (odds ratio, 1.21/year; 95% confidence interval, 1.05-1.40) and coronary artery disease (odds ratio, 12.0; 95% confidence interval, 1.20-121) were independent determinants of DbaPWV >= 100 cm/sec after TEVAR, whereas DbaPWV >= 100 cm/sec was not associated with treatment length or device type.Conclusions: TEVAR was associated with PWV progression, especially in older patients with coronary artery disease, whereas treatment length or device type was not a predictor of PWV progression after TEVAR.