Anesthesiologist View on Endovascular Aortic Aneurysm Repair; A Single Center Retrospective Study
Abstract
Objective: Endovascular aortic repair (EVAR) and thoracic endovascular aortic repair (TEVAR), which are minimally invasive endovascular stent grafting methods, are applied as alternatives to traditional and invasive open surgery in the treatment of aortic aneurysms. The aim of this study was to evaluate the anesthesia methods applied in patients who underwent EVAR and TEVAR in our hospital.
Materials and Methods: The files of 95 patients who underwent endovascular aortic repair between 01.01.2015 and 31.05.2022 were reviewed retrospectively. Descriptive data on patients, as well as data such as the duration of surgery, intensive care and hospital stay were collected and evaluated.
Results: It was determined that endovascular aortic grafting was performed under general anesthesia (GA) (Group GA) in 14 patients and with sedo-analgesia (SA) (Group SA) in 67 patients. EVAR was administered to 75 patients and TEVAR to 6 patients. Eleven of the EVAR patients received GA and 64 received SA. The mean age of the patients was 68.73±8.31 years, and 75 of the patients were male. There was no significant difference between the groups with regards to comorbidities (p>0.05). When the length of stay in the intensive care unit was evaluated in terms of duration of hospitalization, there was no statistically significant difference between the groups (p>0.05).
Conclusion: In this study, GA and SA gave similar outcomes an in patients who underwent EVAR/TEVAR in our clinic, except for the intraoperative fluid requirements.
Keywords
General anesthesia , sedo-analgesia , endovascular aort repair
References
- Greenhalgh RM, Brown LC, Kwong GP, Powell JT, Thompson SG. EVAR trial participants. Comparison of endovascular aneurysm repair with open repair in patients with abdominal aortic aneurysm (EVAR trial 1), 30-day operative mortality results: randomised controlled trial. Lancet. 2004;364:843–8.
- Parodi JC, Palmaz JC, Barone HD. Transfemoral intraluminal graft implantation for abdominal aortic aneurysms. Ann Vasc Surg. 1991 Nov;5(6):491-9.
- Elkouri S, Gloviczki P, McKusick MA, Panneton JM, Andrews J, Bower TC, et al. Perioperative complications and early outcome after endovascular and open surgical repair of abdominal aortic aneurysms. Journal of vascular surgery. 2004;39(3):497-505.
- Köksal C, Özcan V, Sarıkaya S, Meydan B, Zengin M, Numan F. Torakal ve abdominal aort anevrizmalarının endovasküler tedavisi. Turkish J Thorac Cardiovasc Surg. 2004;12:184-7.
- Franz R, Hartman J, Wright M. Comparison of anesthesia technique on outcomes of endovascular repair of abdominal aortic aneurysms: a five-year review of monitored anesthesia care with local anesthesia vs. general or regional anesthesia. J Cardiovasc Surg (Torino). 2011;52(4):567-77
- Armstrong RA, Squire YG, Rogers CA, Hinchliffe RJ, Mouton R. Type of anesthesia for endovascular abdominal aortic aneurysm repair. J Cardiothorac Vasc Anesth. 2019;33(2):462-71. doi:10.1053/j.jvca.2018.09.018
- Bakker EJ, van de Luijtgaarden KM, van Lier F, Valentijn TM, Hoeks SE, Klimek M, et al. General anaesthesia is associated with adverse cardiac outcome after endovascular aneurysm repair. Eur J Vasc Endovasc Surg. 2012 Aug;44(2):121-5. doi: 10.1016/j.ejvs.2012.04.028. Epub 2012 May 22.
- Karthikesalingam A, Thrumurthy SG, Young EL, Hinchliffe RJ, Holt PJ, Thompson MM. Locoregional anesthesia for endovascular aneurysm repair. J Vasc Surg. 2012;56(2):510-9. doi:10.1016/j.jvs.2012.02.047
- Edwards MS, Andrews JS, Edwards AF, Ghanami RJ, Corriere MA, Goodney PP, et al. Results of endovascular aortic aneurysm repair with general, regional, and local/monitored anesthesia care in the American College of Surgeons National Surgical Quality Improvement Program database. J Vasc Surg. 2011;54(5):1273-82. doi: 10.1016/j.jvs.2011.04.054. Epub 2011 Jul 1.
- Kaya S, Turhan Ö, Sungur Z, Sayın ÖA, Alpagut U, Şentürk M. Endovasküler girişimlerde anestezi yönetimi ve klinik sonuçlarının retrospektif değerlendirilmesi. GKDA Derg. 2018;24(4):152-9