Patients treated with endovascular procedures need the same preoperative optimization of medical treatment, smoking cessation, etc. as those undergoing conventional open surgery, for lowest peri- and postoperative morbidity and mortality, but more so for the long-term results.
Patients treated with endovascular therapy peripherally, e.g. percutaneous transluminal angioplasty or iliac or carotid stent implantation, as well as peripheral fibrinolysis are most often cared for in a postoperative unit with close monitoring, but there is usually no need for admission to the intensive care unit.
Patients treated for aneurysmal disease with stent graft usually have a much easier recovery and fewer postoperative complications than those treated with open repair. Thus the need for peri- and postoperative monitoring is less extensive in these patients. There are fewer cardiac complications both peri- and postoperatively when comparing patients with the same degree of preoperative heart disease. This is probably due to the much smaller total surgical trauma, but in particular the fact that aortic cross clamping is not needed during the procedure. However, patients not fit for conventional surgical aortic aneurysm repair due to a combination of co-morbid conditions are now receiving aortic stent graft treatment, and these patients are at increased risk of postoperative complications . The level of postoperative monitoring will naturally reflect the patient's preoperative condition and possible adverse events during stent grafting.
In these patients in particular, postoperative monitoring of renal function is warranted, due to the use of relatively large quantities of nephrotoxic contrast media, to the problems that may occur upon placing the upper part of the stent above the renal arteries or due to the dislocation of the aneurysm neck thrombosis into the renal arteries . The need for postoperative dialysis must be considered when the patient is suffering from prolonged renal failure. Renal failure is in these patients, as in patients with open repair, associated with a higher postoperative mortality rate .
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