Anaesthetic implications of aortic stent surgery

J, Greiff; Thompson, Matthew M.; Langham, B. T.

doi:10.1093/bja/75.6.779

Cited by 11 publications

(8 citation statements)

References 5 publications

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“…Intraoperative temperature control is easier. There is quicker recovery and postoperative pain is moderate 3,4,6 .…”

Section: Discussionmentioning

confidence: 99%

“…During placement of the aortic endoprosthesis, surgeons may request the reduction, for short periods of time (<1 min), of the mean arterial pressure to values lower than 70 mmHg [1][2][3] . Induced hypotension may reduce the possible risk of hypertension, produced by complete occlusion of the aorta and major arteries during the inflation of the balloon 1,2,6,9 . Not all authors agree with the absolute need for induced hypotension during positioning of the stent.…”

Section: Discussionmentioning

confidence: 99%

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Epidural Anaesthesia for Endovascular Stent Graft Repair of a Ruptured Thoracic Aneurysm

Leykin

Mancinelli

et al. 2003

Anaesth Intensive Care

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We present a case report of the anaesthetic management of a 77-year-old man requiring endovascular thoracic stent graft repair The patient had a history of poorly controlled type II diabetes mellitus and chronic renal failure. Chest X-ray and CT scan shoowed a right pleural effusion, generalized emphysema and an enlarged thyroid extending into the upper mediastinum, compromising the tracheal lumen. Endovascular stent grat repair was successfully performed under epidural anaesthesia and intravenous sedation.

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“…Intraoperative temperature control is easier. There is quicker recovery and postoperative pain is moderate 3,4,6 .…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Epidural Anaesthesia for Endovascular Stent Graft Repair of a Ruptured Thoracic Aneurysm

Leykin

Mancinelli

et al. 2003

Anaesth Intensive Care

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“…40 Embolic events may occur secondary to dislodgement of atherosclerotic plaque in the aorta, and gaseous emboli from air present in the contrast solution.41 Distal extremity circulation is most at risk. 3,8 An important complication among patients undergoing endovascular repair is the failure to totally exclude the AAA from the arterial system.2 This persistent blood flow into the aneurysmal sac is called an endoleak and may result in continued aneurysmal dilatation.12 An endoleak may result in AAA expansion and possible late rupture from inadequate exclusion of the aneurysm. Patients who have endoleaks require close long-term postoperative surveillance.…”

Section: Intraoperative Managementmentioning

confidence: 99%

Endovascular Repair of the Abdominal Aortic Aneurysm

Santamore¹,

Saldanha

Santamore

2003

Semin Cardiothorac Vasc Anesth

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Since the early 1 990s, endovascular surgery has provided another treatment option for the management of abdominal aortic aneurysms. Its shorter postoperative recovery time, absence of an abdominal incision, and avoidance of aortic cross-clamping gives endovascular abdominal aortic aneurysm repair its appeal. New vascular grafts are being developed that may expand the number of eligible candidates. This less-invasive form of abdominal aortic aneurysm repair still provides the anesthesiologist with several challenges. The procedure has been performed under general anesthesia, regional anesthesia, and local anesthesia with monitored anesthesia care. The potential benefits of one anesthetic type over another for endovascular abdominal aortic aneurysm repair have not yet been fully explored. Several intraoperative complications, including acute aortic rupture and misdeployment of the stent graft, can necessitate conversion to an open laparotomy. Endovascular repair in the short term compares favorably to open surgical repair with a reduction in morbidity, blood loss, and hospital stay. Still, endovascular abdominal aortic aneurysm repair is a relatively new corrective modality, and long-term controlled trials comparing it with open repair have not yet been reported. As more research into the technique is performed, new strategies for endovascular abdominal aortic aneurysm repair may further increase the options available to patients. Endovascular surgery is rapidly becoming a common treatment modality for vascular disease. Abdominal aortic aneurysms (AAA), once repaired only by an open surgical procedure, can now be treated via this new minimally invasive technique.' Its shorter postoperative recovery time, the absence of an abdominal incision, and the avoidance of aortic cross-clamping gives endovascular AAA repair its appeal.2'3 Newly designed grafts and wider eligibility criteria allow the technique to be applied to an increasing number of patients.4

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“…The anaesthetic management of patients undergoing endovascular repair of abdominal aortic aneurysms is well described in the literature [1,2] but there is little which describes the detailed anaesthetic management of patients requiring endovascular repair of thoracic aneurysms. We describe our anaesthetic management of a patient undergoing stenting of a thoracic aortic aneurysm at the site of an aortic coarctation.…”

Section: Introductionmentioning

confidence: 99%

Anaesthesia for stent graft repair of thoracic aneurysm and coarctation of the aorta

Strachan

Edwards

2001

Eur J Anaesthesiol

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We present the anaesthetic management of a patient for stenting of a thoracic aortic aneurysm at the site of an aortic coarctation. The specific challenges to the anaesthetist for this case are outlined. These include the specific problems of placing the graft, the obvious risk of aortic rupture and the unfamiliar environment of the separate radiological theatre. The advantages and disadvantages to the anaesthetist of the treatment of thoracic aortic aneurysms with stents are briefly discussed.

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Anaesthetic implications of aortic stent surgery

Abstract: We present a case of abdominal aortic aneurysm repair using a new technique of aortic stenting and discuss the anaesthetic technique used and the perioperative advantages of the technique.

Cited by 11 publications

References 5 publications

Epidural Anaesthesia for Endovascular Stent Graft Repair of a Ruptured Thoracic Aneurysm

Epidural Anaesthesia for Endovascular Stent Graft Repair of a Ruptured Thoracic Aneurysm

Endovascular Repair of the Abdominal Aortic Aneurysm

Anaesthesia for stent graft repair of thoracic aneurysm and coarctation of the aorta

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