Endovascular repair of the aorta is a relatively new technique using stents passed through an artery (usually femoral) and guided to the aorta via fluoroscopy. The patient must be motionless during the procedure; but general, neuraxial, or local anesthesia is appropriate. Local anesthesia has the advantage of requiring less fluid and vasopressor support, although the same degree of pulmonary and cardiac complications occur when compared to general anesthesia. Usually only an arterial line and standard monitors are necessary, but conversion to an open procedure is possible, and aggressive intravenous access is justified. Overall endovascular techniques require less fluid and hemodynamic support, and the 30-day mortality for abdominal aortic aneurysms is less than that for open repairs (3% vs. 4%). The cardiac, pulmonary, renal, and bleeding complications are fewer as well.
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