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Text
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URL Address
<a href="http://doi.org/10.1177/0885066617730571" target="_blank" rel="noreferrer noopener">http://doi.org/10.1177/0885066617730571</a>
Pages
394–406
Issue
7
Volume
33
Dublin Core
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Title
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Complications and Perioperative Management of Patients Undergoing Thoracic Endovascular Aortic Repair.
Publisher
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Journal of intensive care medicine
Date
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2018
2018-07
Subject
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*Endovascular Procedures; *Postoperative Complications/diagnostic imaging/physiopathology/surgery; Aorta; Aortic Aneurysm; aortic syndrome; Blood Vessel Prosthesis Implantation; complications; Coronary Angiography; Embolism; endograft; endovascular; Endovascular Procedures; Equipment Failure/*statistics & numerical data; Fistula; Humans; Ischemia; Kidney – Injuries; medical management; Mesenteric Ischemia; Perioperative Care; Postoperative Complications – Therapy; Practice Guidelines as Topic; Retrospective Studies; Spinal Cord – Pathology; Spinal Cord Ischemia/diagnostic imaging/*etiology; stent graft; Stents; Stroke; Thoracic – Surgery; thoracic aorta; Thoracic/physiopathology/*surgery; Treatment Outcome
Creator
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Sattah Anna P; Secrist Michael H; Sarin Shawn
Description
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Endovascular treatments have become increasingly common for patients with a variety of thoracic aortic pathologies. Although considered less invasive than traditional open surgical approaches, they are nonetheless complex procedures. Patients undergo manipulation of an often calcified aorta near the origin of the carotid and subclavian vessels and have stents placed in a curved vessel adjacent to a perpetually beating heart. These stents can obstruct blood flow to the spinal cord, induce an inflammatory response, and in rare cases erode into the adjacent trachea or esophagus. Renal complications range from contrast-induced nephropathy to hypotension and ischemia to dissection. Emboli can lead to strokes and mesenteric ischemia. These patients have complex medical histories, and skilled perioperative management is critical to achieving the best clinical outcomes. Here, we review the medical management of the most common complications in these patients including stroke, spinal cord ischemia, renal injury, retrograde dissections, aortoesophageal and aortobronchial fistulas, postimplantation syndrome, mesenteric ischemia, and endograft failure.
Identifier
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<a href="http://doi.org/10.1177/0885066617730571" target="_blank" rel="noreferrer noopener">10.1177/0885066617730571</a>
Rights
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Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
*Endovascular Procedures
*Postoperative Complications/diagnostic imaging/physiopathology/surgery
2018
Aorta
Aortic Aneurysm
aortic syndrome
Blood Vessel Prosthesis Implantation
complications
Coronary Angiography
Embolism
endograft
endovascular
Endovascular Procedures
Equipment Failure/*statistics & numerical data
Fistula
Humans
ischemia
Journal of intensive care medicine
Kidney – Injuries
medical management
Mesenteric Ischemia
Perioperative Care
Postoperative Complications – Therapy
Practice Guidelines as Topic
Retrospective Studies
Sarin Shawn
Sattah Anna P
Secrist Michael H
Spinal Cord – Pathology
Spinal Cord Ischemia/diagnostic imaging/*etiology
stent graft
Stents
stroke
Thoracic – Surgery
thoracic aorta
Thoracic/physiopathology/*surgery
Treatment Outcome