Feasibility of endovascular repair of abdominal aortic aneurysms with local anesthesia with intravenous sedation

Henretta, John P.; Hodgson, Kim J.; Mattos, Mark A.; Karch, Laura A.; Hurlbert, Scott N.; Sternbach, Yaron; Ramsey, Don E.; Sumner, David S.

doi:10.1016/s0741-5214(99)70205-3

Cited by 111 publications

(67 citation statements)

References 15 publications

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“…In the first 30 days, noncardiopulmonary complications developed in only 3 patients [24]. Cao et al, performed epidural anesthesia for 54% of 61 patients undergoing elective EVAR.…”

Section: Discussionmentioning

confidence: 99%

Anesthetic Management and Perioperative Complications in Endovascular Interventions: The Turkish Experience

Erkılıç¹,

Kesimci²,

Döğer³

et al. 2015

Glob J Anesth

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Background and Aim: Thoracic, abdominal and thoraco-abdominal aortic pathologies have highest mortality and morbidity causing pathologies in cardiovascular surgery. Co-existing diseases and age significantly increase risk of anesthesia and mortality rate in treatment of these patients. Endovascular techniques are used increasingly due to minimally invasive approach, decreased anesthesia risk during implementation, reduced length of hospital stay, and low mortality and mobidity rates. The aim of this investigation was to report our anesthetic experiences in endovascular techniques performed at our center. Materials and Methods:We evaluated 120 (19 females, 101 males; mean age: 67±12 years) consecutive symptomatic patients with thoracic and abdominal aortic pathologies who underwent endovascular stent graft surgery with either general or regional anesthesia or sedoanalgesia between 2009 and 2014, at our center. Results:The number of patients having abdominal endovascular stent graft surgery was 81. Among the rest; 87% underwent thoracic endovascular aneurysm repair, while 13% had both of the interventions. The duration of anesthesia and surgery was not different among the intervention groups. 86.8% of patients had general anesthesia, while 12.3% and 0.9% had regional anesthesia and sedoanalgesia; respectively. Postoperatively, the rate of being intubated and the length of stay in intensive care unit were found significantly lower in endovascular aortic repair (EVAR) group.Conclusion: EVAR should be considered as a beneficial alternative treatment option for high-risk and inoperable, elderly patients. Anesthesiological approach to be selected in these patients may be affected not only by general condition and cooperation of the patient, but also by the location of the pathology and duration of the process. Thus, the anesthesiologists should be prepared to face issues related to the patient's safety both during the administration of anesthesia and in the postoperative period.for a consecutive series of patients who underwent endovascular abdominal and thoracalaneurysm repair in our institution within a 5-year period.

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“…In the first 30 days, noncardiopulmonary complications developed in only 3 patients [24]. Cao et al, performed epidural anesthesia for 54% of 61 patients undergoing elective EVAR.…”

Section: Discussionmentioning

confidence: 99%

Anesthetic Management and Perioperative Complications in Endovascular Interventions: The Turkish Experience

Erkılıç¹,

Kesimci²,

Döğer³

et al. 2015

Glob J Anesth

View full text Add to dashboard Cite

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“…O reparo de aneurismas via endovascular pode ser feito sob diversas técnicas anestésicas, anestesia geral, anestesia regional e anestesia local associada à sedação [24][25][26] . A influência da técnica anestésica para o procedimento ainda precisa ser elucidada; contudo, existem situações em que uma técnica se sobrepõe à outra.…”

Section: Técnica Anestésicaunclassified

“…Quando a opção for por bloqueios espinais, deve-se estar atento ao intervalo necessário entre o bloqueio e a heparinização para que seja mínima a prevalência de hematomas peridurais, que, sabidamente, aumenta quando o bloqueio é realizado há menos de duas horas da heparinização. Hernetta e col. descreveram o uso da anestesia local associada à sedação em 47 pacientes 25 . Destes, apenas um demandou conversão para anestesia geral e todos apresentavam comorbidades significativas.…”

Section: Técnica Anestésicaunclassified

“…Hernetta e col. demonstraram perda sangüí-nea média no procedimento endovascular de 623 mL com apenas três, num total de 47 pacientes, demandando transfusão de sangue. A necessidade média de fluidos foi de 2.491 mL 25 . Resultado de estudo multicêntrico que comparou a perda sangüínea no procedimento aberto com o endovascular 29 mostrou perda 60% menor no endovascular (650 mL) com relação ao aberto (1.600 mL), o que resultou em menor necessidade de transfusão de sangue nos procedimentos endovasculares (12% versus 40%).…”

Section: Controle Hemodinâmico Intra-operatóriounclassified

“…Endovascular aneurism repair can be done using different anesthetic techniques, such as general anesthesia, regional block, and local anesthesia associated with sedation [24][25][26] . The influence of the anesthetic technique in the procedure has yet to be determined; however, there are times in which one technique is more beneficial than the others.…”

Section: Anesthetic Techniquementioning

confidence: 99%

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Anestesia para intervenção cirúrgica endovascular na aorta abdominal

Lorentz

Boni

Soares

2008

Rev. Bras. Anestesiol.

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Rev Bras AnestesiolARTIGO DE REVISÃO 2008; 58: 5: 520-532 REVIEW ARTICLE RESUMO Lorentz MN, Boni CLA, Soares RR -Anestesia para Intervenção Cirúrgica Endovascular na Aorta Abdominal. JUSTIFICATIVA E OBJETIVOS:O procedimento endovascular para correção de aneurisma de aorta é menos invasivo que o convencional, além de apresentar outras vantagens, como ausência de incisão abdominal, ausência de pinçamento da aorta e menor tempo de recuperação pós-operatória. Por se tratar de procedimento cirúrgico relativamente novo e apresentar uma série de alterações que devem ser conhecidas pelo anestesiologista foi realizado este trabalho com o objetivo de revisar os aspectos mais relevantes do procedimento endovascular e possibilitar manuseio anestésico mais adequado no perioperatório. CONTEÚDO:Apresentação sucinta da técnica cirúrgica para reparo de aneurismas via endovascular, as possíveis vantagens e desvantagens do procedimento, bem como as complicações potenciais. Além disso, foram abordados os cuidados perioperatórios que o procedimento exige e as técnicas anestésicas que podem ser utilizadas. CONCLUSÕES:O conhecimento das alterações provenientes do procedimento endovascular possibilita conduta anestésica mais adequada e melhora dos resultados perioperatórios nesses pacientes.Unitermos: CIRURGIA, Vascular; DOENÇA, Vascular: aneurisma. SUMMARYLorentz MN, Boni CLA, Soares RR -Anesthesia for Endovascular Surgery of the Abdominal Aorta. BACKGROUND AND OBJECTIVES:Endovascular surgery for aneurism of the aorta is less invasive than the conventional procedure besides other advantages such as the absence of abdominal incision, absence of ligature of the aorta, and reduced postoperative recovery time. Since it is a relatively new procedure and to presenting a series of changes that should be known by the anesthesiologist, the objective of this report was to review the most relevant aspects of endovascular surgery, allowing more adequate perioperative anesthetic management. CONTENTS:A brief description of the technique of endovascular aneurism repair, possible vantages and disadvantages of its use, as well as potential complications are discussed. CONCLUSIONS:Knowledge of the changes secondary to the endovascular procedure allows a more adequate anesthetic conduct and improves the postoperative results in those patients.

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