Percutaneous endovascular abdominal aortic aneurysm repair with monitored anesthesia care decreases operative time but not pulmonary complications.
Percutaneous endovascular abdominal aortic aneurysm repair with monitored anesthesia care decreases operative time but not pulmonary complications.
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DOI：
10.1177/17085381211012908
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发表时间：
2022-06
期刊：
影响因子：
1.1
通讯作者：
Bornak A
中科院分区：
文献类型：
--
作者：
Kronenfeld JP;Ryon EL;Lall A;Kang N;Kenel-Pierre S;DeAmorim H;Rey J;Karwowski J;Bornak A
报告我们的经验，并比较在监测麻醉护理（MAC）下进行的经皮主动脉瘤腔内修复术（PEVAR）与在全身麻醉（GA）下进行的PEVAR的结果。完成了对接受非急诊腹主动脉瘤腔内修复术（EVAR）的患者的回顾性审查。如果患者进行了复杂的修复，包括开窗、分支或平行内移植，则将其排除。分析了人口统计学、手术数据、30天死亡率/发病率和术后结局。共确定了159例患者，中位年龄为69岁。115例患者接受PEVAR，45例（39.1%）接受PEVAR MAC，70例（60.9%）接受PEVAR GA。与PEVAR GA相比，PEVAR MAC缩短了手术时间（106 vs. 134 min，P < 0.001）、手术室时间（163 vs. 245 min，P = 0.016）和估计失血量（EBL）（115 vs. 176 mL，P = 0.012）。住院时间（LOS）（1.9 vs. 2.7天，P = 0.133）和术后并发症（包括肺部并发症）（2.2 vs. 2.9%，P = 0.835）无统计学显著差异。44例患者行腹主动脉瘤腔内修复术伴股骨截短（FC），包括14例PEVAR转换。与计划的FC腹主动脉瘤腔内修复术相比，PEVAR转换与更高的EBL（543 vs. 323 mL，P = 0.03）、手术时间（230 vs. 178 min，P = 0.01）和手术室时间（307 vs. 275 min，P = 0.01）相关。与GA下的PEVAR相比，MAC下的PEVAR在手术室中的时间更短。然而，MAC下的PEVAR并未降低总体发病率，包括术后肺部并发症。
To report our experience and compare the results of percutaneous endovascular aortic aneurysm repair (PEVAR) performed under monitored anesthesia care (MAC) to PEVAR under general anesthesia (GA). A retrospective review of patients who underwent non-emergency endovascular abdominal aortic aneurysm repair (EVAR) was completed. Patients were excluded if they had a complex repair, including fenestrated, branched, or parallel endografting. Demographics, operative data, 30-day mortality/morbidity and postoperative outcomes were analyzed. A total of 159 patients were identified with a median age of 69. 115 patients had PEVAR, 45 (39.1%) PEVAR MAC and 70 (60.9%) PEVAR GA. PEVAR MAC compared to PEVAR GA had decreased operative time (106 vs. 134 min, P < 0.001), time in the operating room (163 vs. 245 min, P = 0.016), and estimated blood loss (EBL) (115 vs. 176 mL P = 0.012). There was no statistically significant difference in the hospital length of stay (LOS) (1.9 vs. 2.7 days, P = 0.133), and post-operative complications including pulmonary (2.2 vs. 2.9%, P = 0.835). Forty-four patients had EVAR with a femoral cutdown (FC), including 14 PEVAR conversions. PEVAR conversion was associated with higher EBL (543 vs. 323 mL, P = 0.03), operative time (230 vs. 178 min, P = 0.01), and operating room time (307 vs. 275 min, P = 0.01) compared to planned EVAR with FC. PEVAR under MAC is associated with shorter time in the operating room compared to PEVAR under GA. PEVAR under MAC does however not decrease overall morbidities, including postoperative pulmonary complications.
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DOI：
10.4103/0970-9185.150525
发表时间：
2015-01
期刊：
Journal of anaesthesiology, clinical pharmacology
影响因子：
--
作者：
Das S;Ghosh S
通讯作者：
Ghosh S
影响因子：
0.9
作者：
Almanfi, Abdelkader;Krajcer, Zvonimir
通讯作者：
Krajcer, Zvonimir
影响因子：
0.6
作者：
Franz, R. W.;Nardy, V. J.;Burkdoll, D.
通讯作者：
Burkdoll, D.
影响因子：
2.9
作者：
Krajcer, Zvonimir;Ramaiah, Venkatesh G.;Miller, Larry E.
通讯作者：
Miller, Larry E.
影响因子：
4.3
作者：
Siracuse, Jeffrey J.;Farber, Alik;Schermerhorn, Marc L.
通讯作者：
Schermerhorn, Marc L.