title: Local anaesthesia for endovascular repair of infrarenal aortic aneurysms.
abstract: OBJECTIVE
  The study aimed to analyse and report the results of a 'local anaesthesia first' approach in elective endovascular aneurysm repair (EVAR) patients.
  
  
  METHODS
  Between January 2007 and August 2010, a total of 217 continuous patients (187 men, median age 76 years, range 52-94 years) underwent elective EVAR using this approach, with predefined exclusion criteria for local anaesthesia (LA). A retrospective analysis regarding technical feasibility, mortality, complication and endoleak rate was performed. The results are reported as an observational study.
  
  
  RESULTS
  LA was applied in 183 patients (84%), regional anaesthesia (RA) in nine patients (4%) and general anaesthesia (GA) in 25 patients (12%). Anaesthetic conversion from LA to GA was necessary in 14 patients (7.6%). Airway obstruction (n = 4) and persistent coughing (n = 3) were the most common causes for conversion to GA. Thirty-day mortality in the LA group was 2.7%, with 16/183 patients (8.7%) experiencing postoperative complications. All type I endoleaks (n = 5, 2.7%) occurred in patients with LA and challenging aneurysm morphologies.
  
  
  CONCLUSIONS
  A 'local anaesthesia first' strategy can successfully be applied in 75% of patients undergoing EVAR. The use of LA can impact imaging quality and thus precise endograft placement, which should be considered in patients with challenging aneurysm morphologies.
authors.affiliation: Division of Vascular and Interventional Radiology, Baptist Cardiac and Vascular Institute, Miami, FL 33176, USA. philippgeisbuesch@gmx.de
authors.forename: P
authors.initials: P
authors.lastname: Geisbüsch
authors.forename: B T
authors.initials: BT
authors.lastname: Katzen
authors.forename: R
authors.initials: R
authors.lastname: Machado
authors.forename: J F
authors.initials: JF
authors.lastname: Benenati
authors.forename: C
authors.initials: C
authors.lastname: Pena
authors.forename: A I
authors.initials: AI
authors.lastname: Tsoukas
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000765:Anesthesia, Conduction; D000768:Anesthesia, General; D000772:Anesthesia, Local; D017544:Aortic Aneurysm, Abdominal / Q000401:mortality / Q000601:surgery*; D000075202:Contraindications; D057510:Endovascular Procedures; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative; D011183:Postoperative Complications; D015607:Stents; D015996:Survival Rate