Anesthetic Considerations for Aortic Arch Stenting.

Autor: Zoller JK; Department of Anesthesiology, Washington University, St. Louis, MO. Electronic address: zollerj@wustl.edu., Gregory SH; Department of Anesthesiology, Washington University, St. Louis, MO., Stevens TW; Department of Anesthesiology, Washington University, St. Louis, MO., Sanchez LA; Section of Vascular Surgery, Department of Surgery, School of Medicine, Washington University, St. Louis, MO., Hueneke R; Department of Anesthesiology, Washington University, St. Louis, MO.
Jazyk: angličtina
Zdroj: Journal of cardiothoracic and vascular anesthesia [J Cardiothorac Vasc Anesth] 2019 Nov; Vol. 33 (11), pp. 3163-3175. Date of Electronic Publication: 2019 Feb 08.
DOI: 10.1053/j.jvca.2019.01.058
Abstrakt: With advances in modern day imaging techniques for the aorta, there has been an increasing incidence of vascular diseases involving the aortic arch. Historically, the only treatment option for arch disease has been open arch replacement under circulatory arrest conditions with or without selective cerebral perfusion. However, this open procedure has significant morbidity and mortality, especially in elderly patients with multiple comorbidities. To potentially mitigate the risks associated with open replacement, endovascular arch repair has gained momentum as an alternative treatment option. Currently, aortic arch stenting is being trialed in multiple international medical centers across Europe and the United States. The outcomes data available thus far are promising, which suggest that there likely will be an increase in patients being referred for aortic arch stenting procedures in the future. In this emerging technology review, multiple aspects of the aortic arch stenting procedure are discussed including the currently available endovascular arch devices, the unique surgical and anesthetic considerations for arch stent implantation, and the early outcomes data published to date.
(Copyright © 2019 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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