ICU · Cardiovascular / vascular surgery

Post-Vascular-Surgery ICU — AAA, Carotid & Peripheral Bypass

Also known as Post-vascular surgery · Post-AAA repair · EVAR · Endovascular aneurysm repair · Carotid endarterectomy · CEA · Peripheral bypass · Endoleak · Spinal cord ischaemia · Reperfusion syndrome · Abdominal compartment syndrome · Hyperperfusion syndrome

The post-vascular-surgery ICU patient faces surgery-specific complications. After an open AAA repair: bleeding (the graft anastomosis), the spinal cord ischaemia (the cross-clamping of the thoracoabdominal aorta — the Adamkiewicz artery), the renal failure (the cross-clamp and the embolisation), the colonic ischaemia (the IMA ligation), the reperfusion syndrome (acidosis, hyperkalaemia, myoglobin from the lower-limb reperfusion), and the abdominal compartment syndrome. After an EVAR: the contrast-induced nephropathy, the endoleak (Types I to V), and the access-site complications. After a carotid endarterectomy: the hyperperfusion syndrome (headache, seizure, haemorrhage from the restoration of the flow to a chronically underperfused brain), the cranial nerve injury, and the MI (the carotid patient has the coronary disease). After a peripheral bypass: the graft thrombosis (assess the pulses, re-explore), the graft infection (catastrophic), and the reperfusion syndrome.