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Anesthetic Management of Thoracic Endovascular Aortic Repair

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Evidence-Based Practice in Perioperative Cardiac Anesthesia and Surgery

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Abstract

Endovascular approaches for repair of thoracic aortic disease are increasing in frequency. The indications for intervention include descending thoracic aortic aneurysm, acute and chronic aortic dissection, penetrating aortic ulcer, traumatic aortic injury and ruptured aortic aneurysms. Various anesthetic techniques, including general, regional and local anesthesia have proven safe for these endovascular treatment approaches. Despite the advancement of the technology and surgical experience, the most devastating complications from thoracic endovascular aortic repair (TEVAR) remain spinal cord injury and stroke. Vigorous spinal cord protection protocols have been shown to decrease the incidence and severity of spinal cord ischemia. Long term concerns pertinent to TEVAR are the development of endoleaks, aneurysm rupture, and stent graft migration. Other important concerns are the long term need for imaging surveillance and the costs of the health care related to this procedure.

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Author information

Authors and Affiliations

  1. Department of Cardiothoracic Anesthesiology, Cleveland Clinic Foundation, Cleveland, OH, USA

    Mariya Geube

  2. Anesthesiology Institute, Cleveland Clinic Foundation, Cleveland, OH, USA

    Christopher Troianos

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  1. Mariya Geube
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  2. Christopher Troianos
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Correspondence to Mariya Geube .

Editor information

Editors and Affiliations

  1. Distinguished University Professor Department of Anesthesia and Perioperative Medicine and Department of MedicineDivision of Critical Care Medicine, London Health Sciences Center and St Joseph’s Healthcare London Centre for Medical Evidence, Decision Integrity and Clinical Impact (MEDICI) Western University, London, ON, Canada

    Davy C.H. Cheng

  2. Associate Professor Department of Anesthesia and Perioperative Medicine and Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Centre for Medical Evidence, Decision Integrity and Clinical Impact (MEDICI) Western University, London, ON, Canada

    Janet Martin

  3. Professor of Surgery University of Toronto, Melanie Munk Chair of Cardiovascular Surgery University Health Network, Toronto, ON, Canada

    Tirone David

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Geube, M., Troianos, C. (2021). Anesthetic Management of Thoracic Endovascular Aortic Repair. In: Cheng, D.C., Martin, J., David, T. (eds) Evidence-Based Practice in Perioperative Cardiac Anesthesia and Surgery. Springer, Cham. https://doi.org/10.1007/978-3-030-47887-2_11

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  • DOI: https://doi.org/10.1007/978-3-030-47887-2_11

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