Endovascular stent-graft repair of descending thoracic aortic aneurysms: the nursing implications for care.
Endovascular repair of descending thoracic aortic aneurysms is a minimally invasive procedure performed with the patient under epidural or spinal anesthesia as an alternative to the conventional left thoracotomy repair. A Dacron graft, similar to the one used in the conventional repair, is placed in the thoracic aorta with fluoroscopic guidance via the femoral or iliac artery. Once the graft is in place, the aneurysm is excluded from the general circulation, thereby preventing rupture. Endovascular repair is currently being offered at selected sites to patients who otherwise would not be candidates for surgical repair due to severe comorbidities such as cardiac, pulmonary, or renal disease. As both the technique and the devices become perfected, endovascular stent-graft repair of descending thoracic aortic aneurysms will most likely be offered as a method of treatment in both high- and low-risk patients who are anatomic candidates for the procedure. This article describes the conventional repair and the endovascular repair of descending thoracic aneurysms. It discusses the implications for nursing care in the preoperative and postoperative settings and defines guidelines for the long-term follow-up of patients who undergo endovascular repair.
Latessa
Victoria
V
Mount Sinai Medical Center, New York, New York 10029, USA.
D000359:Aftercare / Q000379:methods; D000792:Angiography; D017130:Angioplasty / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D017545:Aortic Aneurysm, Thoracic / Q000145:classification / Q000175:diagnosis / Q000451:nursing / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D015897:Comorbidity; D005471:Fluoroscopy / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods; D006801:Humans; D008403:Mass Screening / Q000379:methods; D018579:Patient Selection; D019990:Perioperative Care / Q000379:methods / Q000451:nursing; D017410:Practice Guidelines as Topic; D015641:Radiography, Interventional / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods; D012307:Risk Factors; D015607:Stents; D014057:Tomography, X-Ray Computed