Endovascular Abdominal Aortic Aneurysm Repair: Does Anesthesia Type Matter?

Area of Science:

• Vascular Surgery
• Anesthesiology
• Health Services Research

Background:

• Anesthesia choice varies for endovascular abdominal aortic aneurysm repair (EVAR).
• Limited data exists on anesthesia type impact on elective EVAR outcomes.
• Large healthcare systems offer opportunities to study anesthesia effects.

Purpose of the Study:

• To determine the effect of anesthesia type on outcomes for elective EVAR.
• To compare outcomes across different anesthesia modalities in a large patient cohort.

Main Methods:

• Retrospective chart review of 1,206 elective EVAR patients (2010-2017).
• Excluded emergent, nonelective, thoracoabdominal repairs, and conversions to open surgery.
• Analyzed demographic, risk factor, anesthesia, operative, and postoperative data.

Main Results:

• 1,206 patients included: 788 general anesthesia, 164 spinal, 82 epidural, 172 local/monitored anesthesia care (AC).
• Local/monitored AC showed significant differences in length of stay and operative time versus general anesthesia.
• No significant difference in 30-day morbidity or mortality observed among anesthesia groups.

Conclusions:

• Local and regional anesthesia are safe and effective for elective EVAR.
• Anesthesia type does not significantly impact short-term major adverse events in EVAR.
• These findings support the use of local/regional anesthesia for elective EVAR.