Transcaval approach for aortic endoprosthesis insertion. A new anesthetic challenge

Area of Science:

• Vascular Surgery
• Cardiovascular Anesthesiology

Background:

• Endovascular techniques have advanced acute aortic syndrome (AAS) treatment.
• Adequate vascular access is crucial for endovascular repair success.
• Unfavorable anatomy necessitates open surgery or limits treatment options.

Purpose of the Study:

• To present the first case of transcaval aortic endoprosthesis implantation in Spain.
• To discuss the anesthetic implications of this novel approach.
• To review the existing literature on transcaval access for aortic interventions.

Main Methods:

• A novel transcaval access technique was employed for aortic endoprosthesis implantation.
• Anesthetic management strategies were implemented and observed.
• A comprehensive literature review was conducted.

Main Results:

• Successful transcaval aortic endoprosthesis implantation was achieved in a patient with unfavorable anatomy.
• The anesthetic management was detailed, highlighting safety and efficacy.
• This case represents a new option for patients unsuitable for traditional endovascular or open surgical approaches.

Conclusions:

• Transcaval access is a viable alternative for endovascular aortic repair in select patients with challenging vascular anatomy.
• Anesthetic management for transcaval aortic procedures requires careful consideration due to limited evidence.
• This approach expands treatment possibilities for acute aortic syndrome.