Contemporary Analysis of Descending Thoracic and Thoracoabdominal Aneurysm Repair

Greenberg, Roy K.; Lu, Qingsheng; Roselli, Eric E.; Svensson, Lars; Moon, Michael; Hernandez, Adrián V.; Dowdall, Joseph; Cury, Marcelo; Francis, Catherine; Pfaff, Kathryn; Clair, Daniel G.; Ouriel, Kenneth; Lytle, Bruce W.

doi:10.1161/circulationaha.108.769695

Cited by 497 publications

(414 citation statements)

References 49 publications

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“…One of the most important complication of TEVAR is SCI (Spinal cord ischemia).This is a multifactorial pathology and not clearly understood [30][31][32]. There is not a consensus about the application of CSF among the authors, however, it is mostly advised in chosen patients for this procedure [14].…”

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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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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“…Esta complicación se observa con mayor frecuencia en pacientes con endoprótesis que determinen coberturas largas de la aorta, siendo un punto crítico más de 20 cms, antecedente de cirugía aórtica abdominal previa, cierre del origen de la subclavia izquierda, ausencia de hipogástricas por disminución de circulación colateral [20][21][22] .…”

Section: Discussionunclassified

Manejo endovascular de las complicaciones agudas de la disección aórtica tipo B

et al. 2010

Rev. méd. Chile

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“…14) Paralysis can be immediate but is often delayed, with the reported incidence (0%-40%) varying between centers and as a function of the surgery and Crawford classification. 6,8,15,16) Recent reviews focusing on high-volume centers indicate that 5%-11% of cases are accompanied by delayed postoperative paresis or paralysis. 15,16) To understand the mechanisms responsible for ISCI, a number of experimental models have been developed.…”

Section: Electrophysiological Assessmentsmentioning

confidence: 99%

Impact of Aortic Cross-Clamping Time on Peripheral Nerves: Experimental Model

Akdemır¹,

Akdemir

Çavuşoğlu

et al. 2015

ATCS

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Purpose: The present study investigated the correlation between extend aortic cross-clamping time and peripheral nerve injury on rats. Methods: 24 male, Sprague Dawley rats were divided into 3 groups; (a) control group: abdomen was directly closed after reached aorta, and followed by 72 hours, (b) shortterm ischaemia-reperfusion group: peripheral nerve ischemia was induced in rats by supraceliac aortic occlusion for 20 min followed by 72 h of reperfusion, (c) long-term ischaemia-reperfusion group: peripheral nerve ischemia was induced for 30 min followed by 72 h of reperfusion. Preoperative and postoperative, electromyography (EMG) recordings were done. End of 72 h, the sciatic nerves were harvested from each animal for histopathological and biochemical analysis. Results: The mean compound muscle action potential (CMAP) amplitude of long-term ischaemia-reperfusion group was statically significant reduced when compared to the control group (p <0.01). However, the mean distal latency value of long-term ischaemia-reperfusion group was statically significant increased (p <0.01). On the other hand, there were statically significant differences between the results of malondialdehyde, edema and ischemia fiber degeneration grades on control and long-term ischaemia-reperfusion group (p <0.001). Conclusion: This study demonstrated that the extending cross clamping time directly harms the peripheral nerve of rats.

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Contemporary Analysis of Descending Thoracic and Thoracoabdominal Aneurysm Repair

Abstract: Background-Endovascular

Cited by 497 publications

References 49 publications

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

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

Manejo endovascular de las complicaciones agudas de la disección aórtica tipo B

Impact of Aortic Cross-Clamping Time on Peripheral Nerves: Experimental Model

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