DOI: 10.69601/meandrosmdj.1892639 ISSN: 2149-9063

Anesthesia Strategy and Clinical Outcomes in Ruptured Aortic Aneurysm Repair: Insights from EVAR and TEVAR

Yaşar Gökhan Gül, Nurdan Yilmaz
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Background and Objectives: This retrospective study evaluated anesthesia methods in patients undergoing endovascular repair (EVAR or TEVAR) for ruptured abdominal or thoracic aortic aneurysms for the purpose of examining the association between anesthesia choice, patient characteristics, and clinical results. Materials and Methods: Forty-seven consecutive patients treated during the study period were retrospectively analyzed at our university hospital between 2022 and 2023 were included and categorized according to anesthesia technique as general anesthesia (GA) or conscious sedation and local anesthesia (CS-LA). Demographic data, comorbidities, surgical history, perioperative variables, and postoperative outcomes were retrospectively recorded and analyzed. Results: The age distribution showed a median value of 70 years [IQR: 64–76], and five patients were female. COPD showed a higher prevalence in the CS-LA group compared with the GA group (30.4% vs. 8.3%, p = 0.049). An ICU stay longer than one day occurred more frequently in patients receiving GA than in those managed with CS-LA (25% vs. 8.7%, p = 0.045). Groups did not differ significantly with respect to early mortality rates between the anesthesia groups (p > 0.05). When patients were stratified by ICU length of stay, diabetes mellitus was significantly associated with prolonged ICU admission (50% vs. 12.8%, p = 0.033). Conclusions: In conclusion, anesthesia choice was associated with differences in ICU stay duration and comorbidity distribution. GA was more often selected for patients with prior surgical history, whereas CS-LA was preferentially selected for patients with COPD, suggesting that anesthesia strategy may be tailored to patient characteristics in ruptured EVAR/TEVAR cases.

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