title: Anesthetic considerations for endovascular aortic repair.
abstract: Endovascular aortic repair is a new alternative to conventional surgical techniques. A variety of devices available for endovascular aortic repair are discussed and the outcomes after repair are reviewed. Anesthetic considerations during endovascular repair are dictated by the device being used, as well as the site of device deployment. Requirements for the optimization of hemodynamic states during proximal graft deployment are described, as well as the available options for induction of ventricular asystole. Since arterial rupture is always a risk when using this procedure, appropriate facilities must be present for resuscitation. Patients undergoing repair of thoracic aortic pathology may be candidates for perioperative transesophageal echocardiographic monitoring. Since a subgroup of these patients may be at risk for postoperative paraplegia, aggressive spinal cord protection should be considered. Patients with large aneurysms may be at risk for "post-implantation syndrome," which is characterized by hyperpyrexia, hypotension, and coagulopathy.
authors.affiliation: Department of Anesthesiology, Box 1010, Mount Sinai School of Medicine, One East 100th Street, New York, NY 10029, USA.
authors.forename: Ronald A
authors.initials: RA
authors.lastname: Kahn
authors.forename: David M
authors.initials: DM
authors.lastname: Moskowitz
authors.forename: Michael
authors.initials: M
authors.lastname: Marin
authors.forename: Larry
authors.initials: L
authors.lastname: Hollier
mesh_terms: D000758:Anesthesia / Q000009:adverse effects / Q000379:methods*; D001014:Aortic Aneurysm / Q000000981:diagnostic imaging / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods; D017548:Echocardiography, Transesophageal; D006801:Humans; D015607:Stents; D014656:Vascular Surgical Procedures / Q000009:adverse effects / Q000379:methods*