Intensive Care After Neuroendovascular Procedures

Endovascular therapy for cerebrovascular disease is widespread. Patients with brain aneurysms, acute stroke, brain vascular malformations, and tumors are treated with endovascular techniques primarily or in conjunction with other traditional surgical and medical approaches. Postprocedural concerns unique to endovascular treatment include complications related to access or arterial puncture, contrast nephrotoxicity, and radiation dose complications (eg, alopecia and skin burns). Other complications, such as stroke and hemorrhage, that are not unique are discussed below.

Detection of Complications After Aortic Stent Grafting

Today, endovascular aortic aneurysm repair (EVAR) is used as an alternative to open surgery. Although the peri-procedural mortality rate is lower with EVAR, there is a high rate of re-intervention that makes long-term surveillance necessary; therefore, we reviewed the possible complications that can occur after EVAR and focused on the different imaging strategies used for follow-up. So far, multidetector computed tomography angiography (MDCTA) is the most widely accepted surveillance method, but carries the risk of radiation and contrast nephrotoxicity. Radiography, MRA, duplex and contrast-enhanced ultrasonography can also provide high-quality imaging, each with its own advantages and limitations. The ideal follow-up protocol (time intervals and type of imaging modality) needs to be further defined in order to ensure proper endograft function and prevent complications.