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ITALIAN JOURNAL OF VASCULAR AND ENDOVASCULAR SURGERY

A Journal on Vascular and Endovascular Surgery


Official Journal of the Italian Society of Vascular and Endovascular Surgery
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Giornale Italiano di Chirurgia Vascolare 1999 June;6(2):119-27

language: English, Italian

Aortic endo­vas­cu­lar graft­ing. A com­par­i­son ­between ­local and gen­er­al anaesthe­sia

Parlani G., Barzi F. *, Verzini F., Caporali S., De Rango P., Zannetti S., Maselli A. *, Simoncini F. **, Cao P.

From the Vascular Surgery Unit
* Department of Radiology
** Department of Anaesthesia and Resuscitation
Policlinico Monteluce, Perugia, Italy


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Background. The aim of the ­present ­study was to eval­u­ate the fea­sibil­ity of endo­vas­cu­lar ­repair of abdom­i­nal aor­tic aneu­rysms (AAA) ­under ­local anaesthe­sia.
Methods. Between November 1, 1996 and June 6, 1998, nine­ty-one ­patients under­went endo­vas­cu­lar ­repair of AAA at the Unit of Vascular Surgery, Policlinico Monteluce, Perugia. Seven ­patients, oper­at­ed ­with a ­first gen­er­a­tion ­device, and 3 ­patients requir­ing con­ver­sion to ­open ­repair ­were exclud­ed ­from the ­present ­study. Thus, the ­study ­cohort was com­posed of 81 ­patients under­go­ing endo­vas­cu­lar AAA ­repair ­with the Aneurx ­stent ­graft: 41 ­under ­local anaesthe­sia (­group A), and 40 ­under gen­er­al anaesthe­sia (­group B).
Results. Four ­patients (9%) ­required con­ver­sion ­from ­local to gen­er­al anaesthe­sia. No sig­nif­i­cant dif­fer­enc­es ­were ­observed ­between the two ­groups ­with ­respect to oper­at­ing ­time, flu­o­ro ­time, ­amount of con­trast ­media ­used, ­blood ­loss or trans­fused ­blood, ­major post­op­er­a­tive mor­bid­ity ­occurred in 3 ­patients ­from ­Group B (7.5%), and in no ­patients in ­Group A (p=0.11).
Patients in ­Group B had a sig­nif­i­cant­ly long­er ­stay in the inten­sive ­care ­unit ­than ­patients in ­Group A (5/40 vs 0/40, p=0.02). Patients in Group B ­were hos­pit­al­ised for a long­er peri­od of ­time (3.4 vs 2.6, p=0.3).
Conclusions. The use of ­local anaesthe­sia is fea­sible for the endo­vas­cu­lar treat­ment of AAA and is asso­ciat­ed ­with a reduc­tion in inten­sive ­care ­unit ­stay, and hos­pi­tal ­stay.

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