Carbon Dioxide Flushing Technique to Prevent Cerebral Arterial Air Embolism and Stroke During TEVAR. (April 2016)

• Record Type: Journal Article
• Authors: Kölbel, Tilo; Rohlffs, Fiona; Wipper, Sabine; Carpenter, Sebastian W.; Debus, Eike Sebastian; Tsilimparis, Nikolaos
• Is Part Of: Journal of endovascular therapy. Volume 23:Number 2(2016:Apr.)
• Page Start: 393
• Page End: 395
• Publication Date: 2016-04
• Subjects: air embolism -- aortic dissection -- carbon dioxide -- endovascular repair -- stent-graft -- stroke -- thoracic aorta -- thoracic aortic aneurysm -- thoracic endovascular aortic repair; Blood-vessels -- Endoscopic surgery -- Periodicals; Angioscopy -- Periodicals; Intravenous catheterization -- Periodicals; Peripheral vascular diseases -- Treatment -- Periodicals; Vascular Surgical Procedures -- Periodicals; Angioscopy -- Periodicals; Catheterization, Peripheral -- Periodicals; Peripheral Vascular Diseases -- therapy -- Periodicals; Angioscopie; Maladies vasculaires périphériques; 617.413
• DOI: 10.1177/1526602816633705
• Languages: English
• ISSNs: 1526-6028

Abstract

Purpose: To describe the technique of carbon dioxide (CO2 ) flushing of thoracic stent-grafts to reduce the risk of cerebral air embolism.Technique: To remove room air, thoracic stent-grafts were preoperatively flushed 2 minutes with carbon dioxide from a cylinder connected to the flushing chamber of the captor valves of Zenith custom-made endografts; this was followed by the standard saline flush. Thirty-six patients undergoing thoracic endovascular aortic repairs (TEVAR) involving the ascending aorta and the aortic arch received CO2 -flushed Zenith endografts. One patient with a highly calcified arch experienced a minor stroke.Conclusion: Arterial air embolism is a potentially underappreciated problem of aortic endografting, especially in the proximal segments of the aorta. CO2 flushing may have the potential to reduce air embolization during TEVAR.