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Aortobifemoral surgery anesthesia

Danielle C Sutzko, Elizabeth A Andraska, Andrea T Obi, Peter K Henke, Nicholas H Osborne
BACKGROUND: Among patients undergoing noncardiac surgery, major vascular surgery is associated with a high risk of perioperative myocardial infarction (MI). Currently, there are no perioperative MI risk calculators accounting for intraoperative and postoperative risk factors in vascular surgery patients. We aimed to investigate specific risk factors for perioperative MI after major open vascular surgery to determine which patients are at highest risk of MI and the association of perioperative MI with perioperative transfusion...
February 2018: Annals of Vascular Surgery
Didem Melis Oztas, Cagla Canbay, Yilmaz Onal, Metin Onur Beyaz, Omer Ali Sayin, Mehmet Barburoglu, Mehmet Buget, Mesut Yornuk, Aziz Ari, Murat Ugurlucan, Bulent Acunas, Ufuk Alpagut, Enver Dayioglu
Treatment of thoracic aortic aneurysms constitutes high mortality and morbidity rates despite improvements in surgery, anesthesia, and technology. Endovascular stent grafting may be an alternative therapy with lower risks when compared with conventional techniques. However, sometimes the branches of the aortic arch may require transport to the proximal segments prior to successful thoracic aortic endovascular stent grafting. Atherosclerosis is accounted among the etiology of both aneurysms and occlusive diseases that can coexist in the same patient...
2017: Case Reports in Medicine
Ömer Karaca, Sezen Kumaş Solak, Serdar Demirgan, Mehmet Bademci
Horner syndrome is rarely observed in connection with epidural anesthesia. It is characterized by ptosis, enophthalmos, miosis, anisocoria, and conjunctival hyperemia in the affected eye, as well as anhydrosis and flushing on the affected side of the face. It is usually a complication spontaneously resolved without permanent neurological deficits. Intraoral anesthesia; stellate ganglion, cervical or brachial plexus blocks; thoracic, lumbar or caudal epidural anesthesia, and intrapleural analgesia are the main causes for Horner syndrome related to anesthesia...
July 2016: Aǧrı: Ağrı (Algoloji) Derneği'nin Yayın Organıdır, the Journal of the Turkish Society of Algology
Anjum Saiyed, Reema Meena, Indu Verma, C K Vyas
BACKGROUND: Complete obstruction of the abdominal aorta at the renal artery level is a difficult surgical problem. Aortic clamping and declamping can lead to profound haemodynamic changes, myocardial infarction, ventricular failure or even death may result. These complications are important challenges in anesthetic management of these patients. METHODS: Between August, 2010 and April, 2012, descending thoracic aorta to femoral artery bypass grafting was used to revascularize lower limbs in 11 patients in our institute...
January 2014: Saudi Journal of Anaesthesia
J Ali, R Kumar Chand, R Juneja, Y Mehta, N Trehan
A 63 years old patient with severely impaired pulmonary function presented with bilateral lower limb vascular blockade and was operated for emergency aortobifemoral bypass. The patient was considered to be at very high risk for general anesthesia but doing the case under regional anesthesia was also challenging because of the multiple dermatomal levels needed to be anesthetized and because of the potential of adverse effects with such extensive block. There are only a few reported cases of using combination of central neuraxial blocks...
2012: HSR Proceedings in Intensive Care & Cardiovascular Anesthesia
J M Mendieta, J Rubio, M Elías, R Company
A 61-year-old man diagnosed with advanced stage Leriche syndrome underwent revascularization surgery with placement of an aortobifemoral shunt and prosthesis under combined general and lumbar epidural anesthesia. After 6 hours he developed bilateral lower extremity compartment syndrome with acute anuric kidney failure caused by severe rhabdomyolysis. Thirty hours after surgery the patient suffered cardiac arrest due to hyperkalemia and was unresponsive to advanced cardiopulmonary resuscitation. The delay in diagnosis, in part owing to the epidural block provided for surgery, and loss of muscle mass led to the unfavorable outcome in this case...
March 2004: Revista Española de Anestesiología y Reanimación
O Hartung, Y S Alimi, T Lonjon, P Barthares, L Cador, C Juhan
OBJECTIVE: Descending thoracic aorta to femoral artery bypass (DTAFB) has demonstrated usefulness in the treatment of aorto-iliac occlusive disease but related morbidity and mortality are not negligible. We wanted to determine the feasibility of thoracoscopic DTAFB and to report our clinical experience. MATERIAL AND METHODS: An experimental study was performed on 8 pigs in helicoidal position under general anesthesia with right selective ventilation ). Three trocars were inserted and the descending aorta was dissected )...
October 2003: Journal des Maladies Vasculaires
J K Edoga, K V James, M Resnikoff, K Asgarian, D Singh, J Romanelli
PURPOSE: To describe a laparoscopic technique for resection of infrarenal abdominal aortic aneurysms (AAAs). METHODS: The operation is based on the principle of retroperitoneal reinforced staple exclusion of the aneurysm sac with aortobifemoral or aortoiliac bypass using gas and gasless laparoscopic techniques. Patients were eligible for this procedure if their infrarenal AAAs (with or without iliac artery involvement) were considered appropriate for surgical resection; however, renal or other visceral arterial stenoses, aneurysmal disease requiring surgical treatment, and/or aneurysms of the hypogastric arteries excluded patients from laparoscopic AAA resection...
November 1998: Journal of Endovascular Surgery: the Official Journal of the International Society for Endovascular Surgery
G J Rosenbaum, P J Arroyo, M Sivina
BACKGROUND: The retroperitoneal approach for elective infrarenal aortic procedures is an attractive alternative to the standard transperitoneal approach. In an effort to limit the number of extraneous influences on patient outcome, this approach was performed using epidural anesthesia without the use of endotracheal intubation or general anesthesia. METHODS: From June 1991 through July 1993, 62 consecutive patients with aorto-occlusive or aorto-iliac disease underwent infrarenal aortic repair using the retroperitoneal approach...
August 1994: American Journal of Surgery
R J Hudson, R G Bergstrom, I R Thomson, M A Sabourin, M Rosenbloom, L Strunin
The authors determined the pharmacokinetics of sufentanil, 12.5 iv in patients undergoing elective abdominal aortic surgery. The mean age (+/- SD) of the ten patients was 68.4 +/- 7.9 yr; their mean weight was 74.4 +/- 19.1 kg. Six patients underwent aortobifemoral grafting and four had abdominal aortic aneurysm repair. Serum sufentanil concentrations were determined in samples drawn at increasing intervals over a 24-h period. A three-compartment pharmacokinetic model was fit to the concentration versus time data...
March 1989: Anesthesiology
R J Hudson, I R Thomson, P M Burgess, M Rosenbloom
The pharmacokinetics of alfentanil, 300 IV, were determined in patients undergoing elective abdominal aortic reconstruction. The mean age (+/- SD) of the patients was 64.3 +/- 7.4 yr; their mean weight was 74.7 +/- 13.8 kg. Five patients underwent aneurysm repair and six had aortobifemoral grafting. Serum alfentanil concentrations were measured by gas-liquid chromatography in samples drawn at increasing intervals over a 24-hr period. A three-compartment model was fitted to the concentration versus time data...
January 1991: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
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