2010, Number 1
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Rev Mex Anest 2010; 33 (1)
Anesthetic protocol for percutaneous endovascular treatment of the abdominal aortic aneurysm (AAA). Initial experience in the ISSEMyM Medical Center
Gómez-Ríos N, Rodríguez-Ortega F, Palma-Mercado J, Hernández-Mercado MA, Juárez-Lemus ÁM, Acevedo-Corona A
Language: Spanish
References: 31
Page: 17-22
PDF size: 104.88 Kb.
ABSTRACT
Objective: To report our experience in the treatment of the abdominal aortic aneurysm under our general anesthesia protocol. Setting: Medical Center of «Instituto de Seguridad Social del Estado de México y Municipios».
Methods: Between January of 2006 to January of 2009, clinical records of the patients who met criteria and underwent endovascular aneurism repair, were reviewed. The following variables was analyzed: age and gender, abdominal aortic aneurysm characteristics, anesthetic medication, amount of red blood packs used, hospital stay, morbimortality, surgical and anesthetic complications.
Results: we found a total of 7 patients, of wich 6 were male, with age average of 58.9 years, diameter abdominal aortic aneurysm average of 65.7 mm, all patients underwent general anesthesia protocol for endovascular repair, the average consumption of red blood cell was 0.1 units/patient, hospital stay was 1.7 days; only 2 inherent surgical complications of the endovascular repair were reported.
Conclusion: The endovascular treatment not this free of the complications, thus is due to value what is the best anesthetic procedure to use, since at any time it is possible to be turned to open surgery.
REFERENCES
Dotter C. Transluminally-placed coil spring endarterial tube grafts. Long-term patency in canine popliteal artery. Invest Radiol 1969; 4: 329-32.
Parodi JC, Palmaz JC, Barone HD. Transfemoral intraluminal graft implantation for abdominal aortic aneurysms. Ann Vasc Surg 1991; 5: 491-9.
Chaikof EL, Blankensteijn JD, Harris PL. Reporting standards for endovascular aortic aneurysm repair. J Vasc Surg 2002; 35: 1048-60.
Wheatly GH, Gurbuz AT, Rodríguez-López JA. Midterm outcome in 158 consecutive GORE TAG thoracic endoprostheses: single center experience. Ann Thorac Surg 2006; 81: 1570-7.
White RA, Donayre CE, Walot I, Lippmann M, Woody J, Lee J et al. Endovascular exclusion of descending thoracic aortic aneurysms and chronic dissections: initial clinical results with the AneuRx device. J Vasc Surg 2001; 33: 927-34.
Czerny M, Grimm M, Zimpfer D. Results after endovascular stent graft placement in atherosclerotic aneurysms involving the descending aorta. Ann Thorac Surg 2007; 83: 450-5.
Gorlitzer M, Weiss G, Thalmann M. Combined surgical and endovascular repair of complex aortic pathologies with a new hybrid prosthesis. Ann Thorac Surg 2007; 84: 1971-7.
García-Madrid C, Josa M, Riambau V, Mestres CA, Montaña J, Mulet J. Endovascular vs repair of abdominal aortic aneurysm: a comparison of early and intermediate results in patients suitable for both techniques. Eur J Vasc Endovasc Surg 2004; 28: 365-72.
Peppelenbosch N, Buth J, Harris PL, Van Marrewijk C, Fransen G; EUROSTAR Collaborators. Diameter of abdominal aortic aneurysm and outcome after endovascular aneurysm repair: does size matter? A report from EUROSTAR. J Vasc Sur 2004; 39: 288-97.
Brewster DC, Cronenwett JL, Hallett JW, Johnston KW, Krupski WC, Matsumara JS. Guidelines for the treatment of abdominal aortic aneurysms. Report of a subcommittee of the joint council of the American Association for Vascular Surgery and Society for Vascular Surgery. J Vasc Surg 2003; 37: 1106-1117.
Lee W, Carter JW, Upchurch G, Seeger JM, Huber TS. Perioperative outcomes after open end endovascular repair of intact abdominal aortic aneurysms in the United States during 2001. J Vasc Surg 2004; 39: 491-6.
Lederle FA. Abdominal aortic aneurysm — Open vs endovascular repair. N Engl J Med 2004; 351: 1677-9.
Brown PM, Zelt DT, Sobolev B. The risk of rupture in untreated aneurysms: the impact of size, gender, and expansion rate. J Vasc Surg 2004; 37: 280-4.
Prinssen M, Verhoeven ELG, Buth J. DREAM Trial Group. A randomized trial comparing conventional and endovascular repair of abdominal aortic aneurysms. N Engl J Med 2004; 351: 1607-18.
Bertges DJ, Chow K, Wyers MC, Landsittel D, Frydrych AV, Stavropoulus W. Abdominal aortic aneurysm size regression after endovascular repairs is endograft dependent. J Vasc Surg 2003; 37: 716-23.
Parodi JC. Endovascular repair of abdominal aortic aneurysms and other arterial lesions. J Vasc Surg 1995; 21: 549-557.
Wolf YG, Hill BB, Rubin GD, Fogarty TJ, Zarins CK. Rate of change in abdominal aortic aneurysm diameter after endovascular repair. J Vasc Surg 2000; 32: 108-115.
Fink JG, Gutiérrez VS, Dena EE, Hurtado LL, Zaldívar RF. Tratamiento endovascular del aneurisma de la aorta abdominal en pacientes mayores de 60 años: morbi-mortalidad perioperatoria. Cir Gen 2002; 24: 34-9.
Eid-Lidt G. tratamiento endovascular percutáneo en aorta toraco-abdominal: Estado del arte. Arch Cardiol Mex 2004; 74: S489-94.
Abularrage CJ, Sheridan MJ, Mukherjee D. Endovascular versus «Fast-Track» abdominal aortic aneurysm repair. Vasc Endovasc Surg 2005; 39: 229-36.
Rubin BG, Sanchez LA, Choi ET, Sicard GA. Endoluminal repair of ruptured abdominal aortic aneurysms Ander local anesthesia: initial experience. Vasc Endovasc Surg 2004; 38: 203-07.
Williamson WK, Nicoloff AD, Taylor LM Jr, Moneta GL, Landry GJ, Porter JM. Functional outcome after open repair of abdominal aortic aneurysm. J Vasc Surg 2001; 33: 913-20.
Matsumara JS, Brewster DC, Makaroun MS, Naftel DC. A multicenter controlled clinical trial of open versus endovascular treatment of abdominal aortic aneurysm. J Vasc Surg 2003; 37: 262-71.
Ruppert V, Leurs L, Steckmeier B, Buth J, Umscheid T. Influence of anesthesia type on outcome after endovascular aortic aneurysm repair: An analysis based on EUROSTAR data. J Vasc Surg 2006; 44: 16-21.
Verhoeven EL, Cina CS, Tielliu IF, Zeebregts CJ, Prins TR, Eindhoven GB. Local anestesia for endovascular abdominal aortic aneurysm repair. J Vasc Surg 2005; 42: 402-9.
de Virgilio C, Romero L, Donayre C, Meek K, Lewis RJ, Lippmann M, et al. Endovascular abdominal aortic aneurysm repair with general versus anesthesia: A comparison of cardiopulmonary morbidity and mortality rates. J Vasc Surg 2002; 36: 988-91.
Steib A. Collange O. Anesthesia for other endovascular stenting. Curr Opin Anesthesiol 2008: 519-22.
Sicard GA, Zwolak RM, Sidawy AN, White RA, Siami FS. Endovascular abdominal aortic aneurysm repair: long-term outcome measures in patients at high-risk for open surgery. J Vasc Surg 2006; 44: 229-36.
Blankensteijn JD, de Jong SE, Prinssen M. Two-year outcomes after conventional or endovascular repair of abdominal aortic aneurysms. N Engl J Med 2005; 352: 2398-405.
Greenhalgh RM, Brown LC, Krown LC, Kwong GP, Powell JT, Thompson SG. Comparison of endovascular aneurysm repair with open repair in patients with abdominal aortic aneurysm (EVAR trial 1), 30-day operative mortality results: randomized controlled trial. Lancet 2005; 365: 2179-86.
Brown LC, Epstein D, Manca A, Beard JD, Powell JT, Greenhalgh RM. The UK endovascular aneurysm repair (EVAR) trials: desing, methodology and progress. Eur J Vasc Endovasc Surg 2004; 27: 372-81.