Table of Contents
Advances in Vascular Medicine
Volume 2014 (2014), Article ID 586084, 6 pages
http://dx.doi.org/10.1155/2014/586084
Review Article

Perioperative Hemodynamic Management and Pharmacotherapeutics of Patients Undergoing Thoracic Endovascular Aortic Repair

Division of Cardiothoracic Surgery, Cedars-Sinai Medical Center, 8700 Beverly Boulevard, Los Angeles, CA 90048, USA

Received 30 June 2014; Accepted 16 December 2014; Published 30 December 2014

Academic Editor: David Tanne

Copyright © 2014 Anja Muehle et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Thoracic endovascular aortic repair (TEVAR) has become an attractive alternative treatment option for many patients with specific thoracic aortic disease. New devices and advanced image-guided procedures are continuously expanding the indications and improve neurological outcomes. Hemodynamic management of these patients is a critical aspect in reducing neurological deficit and it is different compared to patients undergoing open thoracic aortic operations. There are two different phases of blood pressure management for patients with thoracic aortic disease. Before and during the critical steps of TEVAR anti-impulsive therapy facilitates safe positioning and stent deployment. After stent grafts are deployed, controlled hypertensive blood pressure levels are achieved to avoid spinal cord ischemia. This precise blood pressure strategy is essential to ensure a safe procedure and good long-term results.