Regional Anesthesia for Endovascular Treatment of Abdominal Aortic Aneurysms

Aadahl, Petter; Lundbom, Jan; Hatlinghus, Staal; Myhre, Hans O.

doi:10.1583/1074-6218(1997)004<0056:rafeto>2.0.co;2

Cited by 53 publications

(20 citation statements)

References 14 publications

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“…It was evident from early experience that it is possible to perform EVAR surgery under different types of anesthesia, including general (GA), regional (RA) and local anesthesia (LA) 12,13 . Non-randomized studies conducted 10 years ago, as well as a systematic review, suggested possible patient benefit when local and/or regional techniques are used for EVAR [14][15][16][17] .…”

Section: Introductionmentioning

confidence: 99%

Type of Anesthesia for Endovascular Abdominal Aortic Aneurysm Repair

Armstrong

Squire

Rogers

et al. 2019

Journal of Cardiothoracic and Vascular Anesthesia

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Objective: Endovascular aneurysm repair (EVAR) is increasingly used in the management of patients with abdominal aortic aneurysms (AAA), including in the emergency setting for ruptured AAA. The lower mortality amongst patients undergoing emergency EVAR under local anesthesia (LA) observed in the IMPROVE trial has sparked renewed interest in the anesthesia choice for EVAR. This systematic review evaluates the effect of mode of anesthesia on outcomes after EVAR. Design: The review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. The primary outcome was inhospital/30-day mortality and both emergency and elective EVAR were included. The relative risk of death was estimated for each individual study without adjustment for potential confounding factors. Setting: Hospitals. Participants: A total of 39,744 patients from 22 non-randomized studies were included in the analysis. Interventions: None Measurements and Main Results: Sixteen studies in 23,202 patients compared LA to GA and reported in-hospital/30-day mortality. The unadjusted risk of death after emergency EVAR with LA was lower than with GA. Trends in elective surgery were less clear. Conclusions: There is some evidence across both emergency and elective settings to suggest that mode of anesthesia may be associated with improved outcomes. In particular, 3 LA appears to have a positive effect on outcome after emergency EVAR. Due to the lack of randomized trial data, a significant risk of confounding remains. The optimal mode of anesthesia for EVAR should be further investigated and the reasons why particular anesthesia techniques are chosen for particular patients identified.

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Section: Introductionmentioning

confidence: 99%

Type of Anesthesia for Endovascular Abdominal Aortic Aneurysm Repair

Armstrong

Squire

Rogers

et al. 2019

Journal of Cardiothoracic and Vascular Anesthesia

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“…Currently, most procedures are performed with epidural anesthesia and conscious sedation reducing the overall length of hospitalization [21]. The need for high-quality fluoroscopic imaging during the procedure should not be underestimated for the success of the program.…”

Section: Design and Classification Of Stent Graftsmentioning

confidence: 99%

Endovascular treatment of abdominal aortic aneurysms: a review

Uflacker¹,

Robison

2001

European Radiology

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Abdominal aortic aneurysm (AAA) is a relatively common disease among the elderly population and may be present in up to 5.9% of the population aged 80 years. Abdominal aortic aneurysm more than 5 cm in diameter are more prone to rupture, with a significant mortality rate. Conventional surgical treatment is quite effective in the lower surgical risk population; however, in the population with a higher risk level the mortality and morbidity significantly increase. The development of less invasive techniques to treat AAA derived from the necessity to reduce the morbidity and mortality. The development of the endovascular endoprostheses was a significant landmark in the management of those patients with AAA, particularly the ones with increased risk. Although the stent-graft technology is still in its infancy, a large amount of information is available and an attempt to summarize this experience is presented herein. An extensive review of the stent-graft technology is presented, including variations in design and classification of the several systems available. Technical aspects of the use of endovascular prostheses are presented, as well as the most recent outcome information available. The problems of endoleaks is discussed and the techniques for treatment and outcomes presented. Finally, a summary of specific information on most of the devices available is presented.

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“…USA), since we are almost never able to exclude the aneurysm by a tube graft. The procedures are carried out under guidance of fluoroscopy, and regional anaesthesia including spinal and epidural anaesthesia is applied [16]. A cutdown is performed to expose the femoral artery tbr insertion of the main graft while the contratateral graft limb is applied percutaneously from the other groin.…”

Section: Infrarenai Abdominal Aortic Aneurysmsmentioning

confidence: 99%

“…Although endovascular treatment is associated with advantages fike a short stay in hospital and a less-pronounced trauma compared with open surgery, there are also disadvantages connected with this treatment. The most important problems are durability of the implants and the occurrence of endoleaks, deformation and dislocation of the endograft and retrograde filling of the aneurysmal sack [8][9][10][11][12][13][14][15][16]. In this review article, we will discuss some aspects of endovascular treatment for aortic dis-…”

Section: Introductionmentioning

confidence: 99%