Skip to main content

Anaesthetic Management of the Endovascular Thoracic Aorta

  • Chapter
  • 965 Accesses

9.5 Conclusion

The anaesthetic management of patients undergoing endovascular treatment is greatly simplified compared with that for patients undergoing open surgery. Nevertheless, the procedure is mainly reserved for patients with high morbidity risk or in a traumatic context. A general anaesthesia enables the insertion of the stent-graft in a highly comfortable condition for the patient and the operators, even more so since it is now possible to moderate the depth of the anaesthesia and to ensure a high degree of security, especially haemodynamic stability.

The evaluation of the technique will enable us to better pinpoint the indications. Should the procedure be extended to patients in good medical condition, or should it still mainly be reserved for older patients with associated comorbidity, which incurs supplementary constraints for the anaesthetic management?

This is a preview of subscription content, access via your institution.

Buying options

Chapter
USD   29.95
Price excludes VAT (USA)
  • DOI: 10.1007/3-540-38309-3_9
  • Chapter length: 4 pages
  • Instant PDF download
  • Readable on all devices
  • Own it forever
  • Exclusive offer for individuals only
  • Tax calculation will be finalised during checkout
eBook
USD   219.00
Price excludes VAT (USA)
  • ISBN: 978-3-540-38309-3
  • Instant PDF download
  • Readable on all devices
  • Own it forever
  • Exclusive offer for individuals only
  • Tax calculation will be finalised during checkout
Softcover Book
USD   279.99
Price excludes VAT (USA)
Hardcover Book
USD   279.99
Price excludes VAT (USA)

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Baker AB, Bookallil MJ, Lloyd G. Intentional asystole during endoluminal thoracic aortic surgery without cardiopulmonary bypass. Br J Anaesth 1997; 78:444–448.

    PubMed  CAS  Google Scholar 

  2. Hashimoto T, Young WL, Aagaard BD, Joshi S, Ostapkovich N, Pile-Spellman J. Adenosine-induced ventricular asystole to induce transient profound systemic hypotension in patients undergoing endovascular therapy. Anesthesiology 2000; 93:998–1001.

    PubMed  CrossRef  Google Scholar 

  3. Kahn RA, Marin ML, Hollier LH, Parson R, Griepp R. Induction of ventricular fibrillation to facilitate endovascular stent graft repair of thoracic aortic aneurysms. Anesthesiology 1998; 88:534–536.

    PubMed  CAS  CrossRef  Google Scholar 

  4. Weigand MA, Motsch J, Bardenheuer HJ. Adenosine-induced transient cardiac arrest for placement of endovascular stent-grafts in the thoracic aorta. Anesthesiology 1998; 89:1037.

    PubMed  CAS  CrossRef  Google Scholar 

  5. Zarins CK, White RA, Schwarten D, Kinney E, Diethrich EB, Hodgson KJ, Fogarty TJ. AneuRx stent graft vs. open surgical repair of abdominal aortic aneurysms: multicenter prospective clinical trial. J Vasc Surg 1999; 29:292–308.

    PubMed  CAS  CrossRef  Google Scholar 

  6. Fuchs RJ, Lee WA, Seubert CN. Transient paraplegia after stent grafting of a descending thoracic aortic aneurism treated with cerebrospinal fluid drainage. J Clin Anesth 2003; 15:59–63.

    PubMed  CrossRef  Google Scholar 

  7. Kahn RA, Faries PL, Leibowitz AB. Anesthetic techniques for endovascular repair of thoracic aortic aneurysms: influence of endovascular device design and prevention of spinal cord ischemia. 2001 ASA meeting abstracts.

    Google Scholar 

  8. Ortiz-Gomez JR, Gonzalez-Solis FJ, Fernandez-Alonzo L. Reversal of acute paraplegia with cerebrospinal fluid drainage after endovascular thoracic aneurysm repair. Anesthesiology 2001;95:1288–1289.

    CrossRef  Google Scholar 

  9. Ling E, Arellano R. Systematic overview of the evidence supporting the use of cerebrospinal fluid drainage in thoracoabdominal aneurysm surgery for prevention of paraplegia. Anesthesiology 2000; 93:1115–1122.

    PubMed  CAS  CrossRef  Google Scholar 

  10. Coplin WM, Avellino AM, Kim DH, Winn HR, Grady MS. Bacterial minigitis associated with lumbar drains: a retrospective cohort study. J Neurol Neurosurg Psychiatry 1999; 67:468–473

    PubMed  CAS  CrossRef  Google Scholar 

  11. Weaver KD, Wiserman DB, Farber M, Ewend MG, Marston W, Keagy BA. Complication of lumbar drainage after thoracoabdominal aortic aneurysm repair. J Vasc Surg 2001; 34:623–627.

    PubMed  CAS  CrossRef  Google Scholar 

  12. Heller LB, Chaney MA. Paraplegia immediately following removal of a cerebrospinal fluid drainage catheter in a patient after thoracoabdominal aortic aneurysm surgery. Anesthesiology 2001; 95:1285–1287.

    PubMed  CAS  CrossRef  Google Scholar 

  13. Killen DA, Weinstein CL, Reed WA. Reversal of spinal cord ischemia resulting from aortic dissection. J Thorac Cardiovasc Surg 2000; 119:1049–1052.

    PubMed  CAS  Google Scholar 

  14. Zimmer S, Heiss MM, Schardey HM, Weilbach C, Faist E, Lauterjung L. Inflammatory syndrome after endovascular implantation of an aortic stent — a comparative study. Langenbecks Arch Chir Suppl Kongressbd 1998; 115(Suppl I):13–17.

    PubMed  CAS  Google Scholar 

  15. Shimazaki T, Ishimaru S, Kawaguchi S, Yokoi Y, Watanabe Y. Blood coagulation and fibrinolytic response after endovascular stent grafting of thoracic aorta. J Vasc Surg 2003; 37(6):1213–1218.

    PubMed  CrossRef  Google Scholar 

  16. Cross KS, Bouchier-Hayes D, Leahy AL. Consumptive coagulopathy following endovascular stent repair of abdominal aortic aneurysm. Eur J Vasc Endovasc Surg 2000; 19(l):94–95.

    PubMed  CAS  CrossRef  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and Permissions

Copyright information

© 2006 Springer-Verlag Berlin Heidelberg

About this chapter

Cite this chapter

Meites, G., Sellin, M. (2006). Anaesthetic Management of the Endovascular Thoracic Aorta. In: Rousseau, H., Verhoye, JP., Heautot, JF. (eds) Thoracic Aortic Diseases. Springer, Berlin, Heidelberg . https://doi.org/10.1007/3-540-38309-3_9

Download citation

  • DOI: https://doi.org/10.1007/3-540-38309-3_9

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-25734-9

  • Online ISBN: 978-3-540-38309-3

  • eBook Packages: MedicineMedicine (R0)