Anesthesia Management in the Endovascular Treatment of Aortic Pathologies
Özet
This chapter comprehensive details anesthesia management in the endovascular treatment of aortic pathologies, focusing on endovascular aortic repair (EVAR) and thoracic endovascular aortic repair (TEVAR) as minimally invasive alternatives to conventional open surgery. These advanced endovascular procedures offer crucial benefits such as lower mortality, shorter hospital stays, and decreased transfusion needs. However, because the patient population is typically elderly and presents significant systemic comorbidities like coronary artery disease and hypertension, thorough preoperative risk assessment using the Revised Cardiac Risk Index (Lee Criteria) is critical. Management strategies also emphasize preserving renal function via hydration and managing chronic pulmonary diseases. Intraoperative monitoring combines basic cardiovascular parameters with advanced tools like transesophageal echocardiography and activated coagulation time tracking. Anesthetic techniques include general anesthesia, regional methods such as spinal or epidural blocks, and local anesthesia combined with sedoanalgesia. Each approach is carefully chosen based on patient-specific risk profiles and surgical duration. Postoperative care in the intensive care unit is essential to monitor for potential complications like rupture, embolism, or postimplantation syndrome. Meticulous preoperative preparation and close coordination between the surgical and anesthesia teams remain vital for success.
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