CC BY 4.0 · The Arab Journal of Interventional Radiology 2023; 07(S 01): S1-S41
DOI: 10.1055/s-0043-1763332
Category: Vascular Interventions

EVARs under Moderate Sedation

Ahmad Alach
1   Kaiser Permanente School of Medicine, Pasadena, California, United States
,
Talha Shabbir
2   California University of Science and Medicine, Colton, California, United States
,
Caleb Solivio
2   California University of Science and Medicine, Colton, California, United States
,
Muhammad Ghauri
2   California University of Science and Medicine, Colton, California, United States
,
Mason Eghbali
2   California University of Science and Medicine, Colton, California, United States
,
George Vatakencherry
3   Kaier Permanente Los Angeles Medical Center, Los Angeles, California, United States
,
Kartik Kansagra
3   Kaier Permanente Los Angeles Medical Center, Los Angeles, California, United States
,
Alok Bhatt
3   Kaier Permanente Los Angeles Medical Center, Los Angeles, California, United States
› Author Affiliations
› Further Information
 

Introduction: Endovascular aortic repair (EVAR) was introduced in 1991 by Parodi et al. Since then, it has grown in popularity as an alternative to open aneurysm repair. Recently, vascular interventionalists have begun performing EVARs under moderate sedation, which reduces the risks of the procedure.

Method(s): The definition, history, and a survey of current usage of moderate sedation for endovascular aneurysm repair will be provided. We will describe techniques of moderate sedation for EVARs in the context of IR practice, touching upon anesthetic technique/choice as well as intraoperative management. The benefits, risks and postoperative considerations for patients who undergo EVAR under moderate sedation will be highlighted.

Result(s): Performing EVARs under moderate sedation eliminates the need for intubation. A variety of agents (e.g., midazolam, fentanyl) can be mixed/used to achieve moderate sedation. Local anesthesia at the puncture site is usually accomplished through the usage of lidocaine, bupivacaine, and bicarbonate.

Conclusion(s): Performing EVARs under moderate sedation presents an exciting opportunity for radiologists. After reviewing this exhibit, the reader will have a better understanding of the moderate sedation EVAR.



Publication History

Article published online:
09 February 2023

© 2023. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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