Abstract
Endovascular treatments have become increasingly common for patients with a variety of thoracic aortic pathologies. Although considered less invasive than traditional open surgical approaches, they are nonetheless complex procedures. Patients undergo manipulation of an often calcified aorta near the origin of the carotid and subclavian vessels and have stents placed in a curved vessel adjacent to a perpetually beating heart. These stents can obstruct blood flow to the spinal cord, induce an inflammatory response, and in rare cases erode into the adjacent trachea or esophagus. Renal complications range from contrast-induced nephropathy to hypotension and ischemia to dissection. Emboli can lead to strokes and mesenteric ischemia. These patients have complex medical histories, and skilled perioperative management is critical to achieving the best clinical outcomes. Here, we review the medical management of the most common complications in these patients including stroke, spinal cord ischemia, renal injury, retrograde dissections, aortoesophageal and aortobronchial fistulas, postimplantation syndrome, mesenteric ischemia, and endograft failure.
| Original language | English |
|---|---|
| Pages (from-to) | 394-406 |
| Number of pages | 13 |
| Journal | Journal of Intensive Care Medicine |
| Volume | 33 |
| Issue number | 7 |
| DOIs | |
| Publication status | Published - 01-07-2018 |
| Externally published | Yes |
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All Science Journal Classification (ASJC) codes
- Critical Care and Intensive Care Medicine
Cite this
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Complications and Perioperative Management of Patients Undergoing Thoracic Endovascular Aortic Repair. / Sattah, Anna P.; Secrist, Michael H.; Sarin, Shawn.
In: Journal of Intensive Care Medicine, Vol. 33, No. 7, 01.07.2018, p. 394-406.Research output: Contribution to journal › Review article
TY - JOUR
T1 - Complications and Perioperative Management of Patients Undergoing Thoracic Endovascular Aortic Repair
AU - Sattah, Anna P.
AU - Secrist, Michael H.
AU - Sarin, Shawn
PY - 2018/7/1
Y1 - 2018/7/1
N2 - Endovascular treatments have become increasingly common for patients with a variety of thoracic aortic pathologies. Although considered less invasive than traditional open surgical approaches, they are nonetheless complex procedures. Patients undergo manipulation of an often calcified aorta near the origin of the carotid and subclavian vessels and have stents placed in a curved vessel adjacent to a perpetually beating heart. These stents can obstruct blood flow to the spinal cord, induce an inflammatory response, and in rare cases erode into the adjacent trachea or esophagus. Renal complications range from contrast-induced nephropathy to hypotension and ischemia to dissection. Emboli can lead to strokes and mesenteric ischemia. These patients have complex medical histories, and skilled perioperative management is critical to achieving the best clinical outcomes. Here, we review the medical management of the most common complications in these patients including stroke, spinal cord ischemia, renal injury, retrograde dissections, aortoesophageal and aortobronchial fistulas, postimplantation syndrome, mesenteric ischemia, and endograft failure.
AB - Endovascular treatments have become increasingly common for patients with a variety of thoracic aortic pathologies. Although considered less invasive than traditional open surgical approaches, they are nonetheless complex procedures. Patients undergo manipulation of an often calcified aorta near the origin of the carotid and subclavian vessels and have stents placed in a curved vessel adjacent to a perpetually beating heart. These stents can obstruct blood flow to the spinal cord, induce an inflammatory response, and in rare cases erode into the adjacent trachea or esophagus. Renal complications range from contrast-induced nephropathy to hypotension and ischemia to dissection. Emboli can lead to strokes and mesenteric ischemia. These patients have complex medical histories, and skilled perioperative management is critical to achieving the best clinical outcomes. Here, we review the medical management of the most common complications in these patients including stroke, spinal cord ischemia, renal injury, retrograde dissections, aortoesophageal and aortobronchial fistulas, postimplantation syndrome, mesenteric ischemia, and endograft failure.
UR - http://www.scopus.com/inward/record.url?scp=85041311558&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85041311558&partnerID=8YFLogxK
U2 - 10.1177/0885066617730571
DO - 10.1177/0885066617730571
M3 - Review article
AN - SCOPUS:85041311558
VL - 33
SP - 394
EP - 406
JO - Journal of Intensive Care Medicine
JF - Journal of Intensive Care Medicine
SN - 0885-0666
IS - 7
ER -