Torakal ve abdominal aort anevrizmalarinin endovasküler tedavisinde anestezi uygulamalari ve klinik sonuçlari

Introduction: Endovascular aortic aneurysm repear (EVAR) for aneurysm treatment has been performed as an alternative treatment modality, particularly in high risk patients. General and regional anesthesia might be preferred in surgical explorations as sedoanalgesia techniques are adequate in percutaneous techniques. In this study, the intended anesthesia techniques and clinical outcomes of patients following Endovascular Stent Grefting (EVSG) were evaluated. Material and Methods: EVAR for abdominal and thoracal aortic aneurysms between 2005-2010 were evaluated retrospectively. The patient's data, anesthesia techiques and related complications, amount of contrast media, total urine output, intensive care unit and hospital duration, requirement for isotonic solutions and inotropic agents, development and treatment of endoleak after EVAR were investigated. The creatine levels were compared with pre-procedure values to evaluate renal functions. The hemodialysis requirement and the duration of ventilatory treatment were also evaluated. Results: The mean age of ASA III-IV, 69 patients were 66.82±9.6 years and male/female ratio was 64/5. The mean duration of the procedure was 168±77 minute and the mean cristalloid, colloid, blood consumption was 911±872 mL, 370±221 mL, 594±879 mL, respectively. Hypotension was occurred in 14.5% (n=10) of patients and were treated with isotonic solutions and inotropic agents. Significant difference was observed between pre- and post-procedure creatine levels (p=0.037). The mean intensive care unit and hospital stays were 2,13±3,9 day and 4.9±3.8 day, respectively. The mortality rate was 7.2% (n=5). The follow-up period was 16.4±10.4 months and type II endoleak was occurred in 39% (n=27) of patients and additional stent was placed under sedoanalgesia in 10% (n=7) of these patients. Conclusion: EVAR procedure and the preferred anesthesia technique in aneurysm repair in high risk patients might improve the survey results.