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.
