Endovascular aneurysm repair: a perioperative perspective

Area of Science:

• Vascular Surgery
• Anesthesiology
• Perioperative Medicine

Background:

• Endovascular aneurysm repair (EVAR) has become the preferred method for treating aortic aneurysms, largely due to improved short-term survival rates compared to open repair.
• Despite widespread adoption, the impact of anesthetic techniques and perioperative management on EVAR outcomes remains under-investigated in large trials.
• Optimal perioperative care is crucial for maximizing the benefits of EVAR and ensuring patient safety.

Purpose of the Study:

• To review current evidence on perioperative management strategies for patients undergoing EVAR.
• To highlight the importance of anesthetic techniques and pharmacological interventions in EVAR.
• To provide a comprehensive overview of surgical considerations and pre-operative assessment for EVAR.

Main Methods:

• Systematic literature review of multicentre EVAR trials and relevant studies.
• Analysis of data focusing on anesthetic techniques, perioperative care, and surgical considerations.
• Synthesis of evidence regarding pharmacological protective strategies in EVAR.

Main Results:

• EVAR demonstrates significantly improved 30-day mortality compared to open repair.
• Limited data exists on the specific effects of different anesthetic approaches on EVAR outcomes.
• Pre-operative assessment and tailored anesthetic plans are critical for patient management.

Conclusions:

• Anesthetic technique and perioperative care significantly influence EVAR outcomes.
• Further research is needed to optimize perioperative management protocols for EVAR.
• A multidisciplinary approach is essential for successful EVAR patient care.