Purpose: To investigate the feasibility of regional anesthesia for end
ovascular repair of abdominal aortic aneurysms (AAAs). Methods: Since
February 1995, 21 patients (17 men and 4 women; median age 67 years, r
ange 49 to 80) have been treated with endovascular technique for true
infrarenal AAA using Mialhe Stenter bifurcated grafts. A single dose o
f spinal anesthesia combined with epidural anesthesia was used in all
procedures. Electrocardiography and arterial blood pressure were monit
ored. Results: No cases of emboli, hematoma, or graft migration were s
een, and there were no reoperations or conversions to open operation.
Arterial blood pressure was stable at a satisfactory level from induct
ion of anesthesia throughout the procedure, and there was no period of
clinically significant hypotension during any implantation. One patie
nt died on the second postoperative day from cardiac and renal insuffi
ciency. Three endoleaks were observed during the procedure; one healed
spontaneously within 5 weeks, and the other two were repaired by endo
vascular techniques after 1 and 4 months, respectively. During follow-
up, one patient died at 6 months from pancreatic carcinoma. Conclusion
s: The application of regional anesthesia is feasible for endovascular
treatment of AAA. The arterial blood pressure remained stable through
out the procedure, and all patients, with two exceptions, were mobiliz
ed on the first day and placed on a regular diet. Based on these early
results, it appears that regional anesthesia is feasible, effective,
and safe for endovascular AAA repair.