经腔途径植入主动脉内假体。新的麻醉挑战。

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引用次数: 0

摘要

与传统的开腹手术治疗相比,近年来血管内治疗技术的巨大进步使急性主动脉综合征的治疗受益匪浅。然而,血管内治疗要取得成功,患者必须有足够的血管通路。那些血管解剖结构不佳的病例必须考虑进行开腹手术,而开腹手术的发病率很高,甚至需要拒绝手术。最近,一种新的腹主动脉手术方法被描述为适用于无法获得其他血管通路、绝对或相对不适合经胸手术的患者。主动脉综合征的麻醉处理方法众所周知,尽管有多种选择,但所有这些方法的安全性和有效性都已得到证实。新手术方法的实施和可能出现的新并发症对麻醉医生来说是一个挑战,而目前几乎没有科学依据。我们介绍了西班牙首例经腔主动脉内假体植入术、其麻醉影响以及文献综述。
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Transcaval approach for aortic endoprosthesis insertion. A new anesthetic challenge
The treatment of acute aortic syndrome has been benefited in recent years from the huge progress in endovascular techniques, compared to classical surgical treatment, by open surgery. Nevertheless, for endovascular treatment to be successful, it is essential for the patient to present adequate vascular access. Those cases with unfavourable vascular anatomy make it necessary to consider open surgery with significant morbidity, or even to reject surgery. A new approach to the abdominal aorta has recently been described as an indication for these patients with impossibility of other vascular access and absolute or relative contraindication to the transthoracic approach.
The anesthetic management of the aortic syndrome is well known and, even though there are a variety of options, all of them have proven safety and efficacy. The implementation of new surgical approaches and new possible complications imply a challenge for the anesthesiologist which, for now, has little or none scientific evidence.
We present the first case of transcaval aortic endoprosthesis implantation in Spain, its anesthetic implications, and a review of the literature.
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