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Less invasive anesthetic methods better for endovascular aneurysm repair
Date:10/27/2011

cifically screen for aneurysms as part of a "Welcome-to-Medicare" visit with their physician. When detected in time, an aortic aneurysm can usually be repaired with surgery.

Infrarenal abdominal aortic aneurysms make up about 95 percent or more of abdominal aortic aneurysms and, while they occur in both sexes, they are most prevalent in men older than 60, affecting about 3 percent of this population, explained study co-author Matthew S. Edwards, B.A., M.S., M.D., a professor of vascular and endovascular surgery and public health sciences at Wake Forest Baptist.

"That's a lot of people," Edwards said. "If aortic aneurysms aren't repaired, they can burst and 80 to 90 percent of people who have a ruptured aortic aneurysm die. It's necessary for those who are suitable candidates for surgery to have their aneurysms repaired."

EVAR has completely revolutionized the care of aneurysms, allowing doctors to do repairs through two small incisions in the groin, Edwards said. It is currently the most common procedure for repairing aortic aneurysms in the United States. Historic trends have led to general anesthesia being the most common mode of anesthesia used for this procedure, but it is sometimes associated with the development of pneumonia, the need for a breathing tube and other pulmonary complications, he explained.

Other anesthetic techniques can also be used, such as local anesthesia, local anesthesia plus sedation (called "monitored" or "MAC"), spinal anesthesia and epidural anesthesia. According to this study, these other methods result in a shortened hospital stay and fewer pulmonary complications.

"In our study, general anesthesia was associated with increased postoperative length of stay (LOS) and increased complications involving the lungs when compared to the other anesthetic methods," Edwards said.

The researchers collected data on 6,009 patients who had elective EVAR performed between 2005 to 2008 at one of
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Contact: Jessica Guenzel
jguenzel@wakehealth.edu
336-716-3487
Wake Forest Baptist Medical Center
Source:Eurekalert

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