scholarly journals Commentary on ‘General Anaesthesia is Associated with Adverse Cardiac Outcome after Endovascular Aneurysm Repair’

2012 ◽  
Vol 44 (2) ◽  
pp. 126
Author(s):  
A. Chaudhuri
Keyword(s):  
General Anaesthesia ◽  
Endovascular Aneurysm Repair ◽  
Adverse Cardiac Outcome ◽  
Cardiac Outcome ◽  
Aneurysm Repair

scholarly journals General Anaesthesia is Associated with Adverse Cardiac Outcome after Endovascular Aneurysm Repair

2012 ◽  
Vol 56 (2) ◽  
pp. 576
Author(s):  
E.J. Bakker ◽  
K.M. van de Luijtgaarden ◽  
F. van Lier ◽  
T.M. Valentijn ◽  
S.E. Hoeks ◽  
...  
Keyword(s):  
General Anaesthesia ◽  
Endovascular Aneurysm Repair ◽  
Adverse Cardiac Outcome ◽  
Cardiac Outcome ◽  
Aneurysm Repair

scholarly journals General Anaesthesia is Associated with Adverse Cardiac Outcome after Endovascular Aneurysm Repair

2012 ◽  
Vol 44 (2) ◽  
pp. 121-125 ◽  
Author(s):  
E.J. Bakker ◽  
K.M. van de Luijtgaarden ◽  
F. van Lier ◽  
T.M. Valentijn ◽  
S.E. Hoeks ◽  
...  
Keyword(s):  
General Anaesthesia ◽  
Endovascular Aneurysm Repair ◽  
Adverse Cardiac Outcome ◽  
Cardiac Outcome ◽  
Aneurysm Repair

Loco-regional versus general anaesthesia for elective endovascular aneurysm repair – results of a cohort study and a meta-analysis

VASA ◽  
2018 ◽  
Vol 47 (3) ◽  
pp. 209-217 ◽  
Author(s):  
Shahin Hajibandeh ◽  
Shahab Hajibandeh ◽  
Kelvin Adasonla ◽  
Stavros A. Antoniou ◽  
Janet Barrie ◽  
...  
Keyword(s):  
Hospital Stay ◽  
General Anaesthesia ◽  
Meta Analysis ◽  
Group Analysis ◽  
Endovascular Aneurysm Repair ◽  
Anaesthetic Techniques ◽  
Perioperative Mortality ◽  
Level Of Evidence ◽  
Mortality And Morbidity ◽  
Aneurysm Repair

Abstract. Background: The aim of this study was to investigate whether patients undergoing elective endovascular aneurysm repair (EVAR) with loco-regional anaesthetic techniques have better outcomes than those treated with general anaesthesia (GA). Patients and methods: We retrospectively evaluated outcomes of EVAR performed with regional anaesthesia (RA) or GA over a five-year period. Furthermore, we searched electronic bibliographic sources (MEDLINE, EMBASE, CINAHL, and CENTRAL) to identify studies comparing different anaesthetic methods in EVAR. We defined perioperative mortality and morbidity as well as length of hospital stay (LOS) as the primary outcome measures. Pooled effect estimates were calculated using fixed-effect or random-effects models. Results are reported as the odds ratio (OR) or mean difference (MD) and 95 % confidence interval (CI). Results: Three hundred and fifty-five patients underwent standard EVAR over the study period (RA, 215 patients; GA 140 patients). Patients in both groups had comparable baseline demographics and clinical characteristics. Perioperative mortality was significantly lower in the RA group (0.5 % vs. 4.3 %, P = 0.017). No difference was found in perioperative morbidity (P = 0.370), LOS (P = 0.146), postoperative destination (P = 0.799), reoperation (P = 0.355) or readmission within 30 days (P = 0.846). Meta-analysis of data on 15,472 patients from 15 observational studies found a significantly lower perioperative mortality (OR 0.70, 95 % CI 0.52–0.95, P = 0.02) and morbidity (OR 0.73, 95 % CI 0.55–0.96, P = 0.02) in patients treated with loco-regional anaesthetic techniques compared to those treated with GA. Our sub-group analysis demonstrated that both local anaesthesia (LA) (P = 0.003) and RA (P < 0.0001) were associated with a significantly shorter LOS compared to GA. Conclusions: Local and/or regional anaesthetic techniques may be advantageous over GA in elective EVAR, as indicated by reduced perioperative mortality and morbidity and a shorter hospital stay. Considering the current level of evidence, LA or RA should be considered in selected patients. Further clinical research is required to provide high level evidence on the optimal anaesthetic technique in EVAR.

Bowel ischaemia after endovascular aneurysm repair

VASA ◽  
2018 ◽  
Vol 47 (4) ◽  
pp. 273-277
Author(s):  
Christopher Lowe ◽  
Oussama El Bakbachi ◽  
Damian Kelleher ◽  
Imran Asghar ◽  
Francesco Torella ◽  
...  
Keyword(s):  
Case Reports ◽  
Endovascular Aneurysm Repair ◽  
Artery Occlusion ◽  
Bibliographic Databases ◽  
Bowel Ischaemia ◽  
Prophylactic Measures ◽  
Increased Risk ◽  
Prisma Statement ◽  
Meta Analyses ◽  
Aneurysm Repair

Abstract. The aim of this review was to investigate presentation, aetiology, management, and outcomes of bowel ischaemia following EVAR. We present a case report and searched electronic bibliographic databases to identify published reports of bowel ischaemia following elective infra-renal EVAR not involving hypogastric artery coverage or iliac branch devices. We conducted our review according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement standards. In total, five cohort studies and three case reports were included. These studies detailed some 6,184 infra-renal elective EVARs, without procedure-related occlusion of the hypogastric arteries, performed between 1996 and 2014. Bowel ischaemia in this setting is uncommon with an incidence ranging from 0.5 to 2.8 % and includes a spectrum of severity from mucosal to transmural ischaemia. Due to varying reporting standards, an overall proportion of patients requiring bowel resection could not be ascertained. In the larger series, mortality ranged from 35 to 80 %. Atheroembolization, hypotension, and inferior mesenteric artery occlusion were reported as potential causative factors. Elderly patients and those undergoing prolonged procedures appear at higher risk. Bowel ischaemia is a rare but potentially devastating complication following elective infra-renal EVAR and can occur in the setting of patent mesenteric vessels and hypogastric arteries. Mortality ranges from 35 to 80 %. Further research is required to identify risk factors and establish prophylactic measures in patients that have an increased risk of developing bowel ischaemia after standard infra-renal EVAR.

Laser-assisted transprosthesial coil embolization combined with thrombin injection for treatment of an endoleak type II after endovascular aneurysm repair

VASA ◽  
2018 ◽  
Vol 47 (1) ◽  
pp. 63-67 ◽  
Author(s):  
Tanja Boehme ◽  
Aljoscha Rastan ◽  
Elias Noory ◽  
Peter-Christian Fluegel ◽  
Thomas Zeller
Keyword(s):  
Coil Embolization ◽  
Endovascular Aneurysm Repair ◽  
Type Ii ◽  
Thrombin Injection ◽  
Endoleak Type Ii ◽  
Aneurysm Repair

Abstract. The treatment of endoleaks type II had to be adapted to the anatomy of each individual patient. The laser-assisted perforation of the prosthesis can be an easier method to reach the aneurysm sac directly than using transarterial or translumbar approaches.

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