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Anaesthesia for vascular radiology 

Anaesthesia for vascular radiology
Chapter:
Anaesthesia for vascular radiology
Author(s):

Dr Jonathan P. Thompson

, Dr Simon J. Howell

, and Dr Richard J. Telford

DOI:
10.1093/med/9780199594429.003.0008
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date: 15 October 2019

Advances in vascular radiology have transformed the management of vascular disease. High-risk vascular patients now regularly undergo complex vascular radiological procedures. These are often carried out by surgeons and radiologists working together. Aortic disease is now frequently treated by endovascular aortic repair (EVAR and TEVAR). EVAR is frequently used for the treatment of leaking or ruptured abdominal aortic aneurysm. Embolisation has found application in the treatment of a wide range of conditions including vascular malformations, tumours and haemorrhage. Anaesthetic assistance is routinely required in the radiology suite to help manage patients undergoing painful or protracted procedures and to care for patients needing close monitoring. Radiological interventions are not without risk. Contrast induced nephropathy is a particular concern. Appropriate perioperative management, in particular maintaining hydration and limiting the dose of contrast, may mitigate the risk of renal injury. The challenges of working in remote sites such as the radiology suite are well known to anaesthetists. It is essential to ensure that appropriate equipment and assistance are available from the outset of the case. The radiology suite can be crowded. Radiological, surgical and anaesthetic teams must work in close cooperation. The use of the WHO checklist is an invaluable aid to team working in these conditions. The anaesthetist must give due attention to personal safety and pay due attention to radiation safety.

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