The Practice of Percutaneous EVAR under Local Anesthesia

Area of Science:

• Vascular Surgery
• Minimally Invasive Procedures
• Anesthesiology

Background:

• Endovascular aortic repair (EVAR) is often preferred for elderly patients with poor surgical tolerance.
• Minimally invasive techniques are crucial for improving patient outcomes in aortic repair.
• Local anesthesia offers a less invasive alternative for EVAR procedures.

Purpose of the Study:

• To evaluate the safety and efficacy of percutaneous EVAR under local anesthesia.
• To compare outcomes of EVAR performed with and without percutaneous techniques under local anesthesia.
• To establish minimally invasive EVAR practices at the hospital.

Main Methods:

• Implementation of percutaneous EVAR using Perclose ProGlide under local anesthesia starting August 2019.
• Comparative analysis of patient demographics and surgical outcomes before and after the introduction of the new technique.
• Inclusion of 148 patients in the study for outcome assessment.

Main Results:

• The percutaneous EVAR group under local anesthesia had significantly higher patient age and prevalence of severe renal dysfunction.
• Operative time was significantly shorter in the percutaneous EVAR group.
• Postoperative hospital stay was significantly reduced in the percutaneous EVAR group.

Conclusions:

• Percutaneous EVAR under local anesthesia is a safe and effective minimally invasive approach.
• This technique is suitable for high-risk patients, including the elderly with severe renal dysfunction.
• The introduction of percutaneous EVAR enhances the hospital's minimally invasive surgical capabilities.