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Chapter: Clinical Cases in Anesthesia : Endovascular Aortic Stent Placement

What is the “post-implantation syndrome”?

The post-implantation syndrome is commonly observed after endovascular aortic repair.

What is the “post-implantation syndrome”?

 

The post-implantation syndrome is commonly observed after endovascular aortic repair. It is character-ized by fever, elevated C-reactive protein levels, and leuko-cytosis in the absence of an infectious agent. It is usually mild and self-limited, lasting from 2 to 10 days postopera-tively and responds to nonsteroidal anti-inflammatory drugs. Occasionally an exaggerated response may result in life-threatening distributive shock, respiratory failure, and disseminated intravascular coagulopathy. It is hypothesized that endovascular aortic aneurysm repair induces a signifi-cant inflammatory response resulting in endothelial cell activation from intra-aneurysmal device manipulation. Although rare, the post-implantation syndrome may present as a consumptive coagulopathy. Endovascular exclusion of a large aortic aneurysm may result in significant thrombus in the excluded aneurysm sac, which may initiate fibrinolysis. Repeated instrumentation of the aorta, which may occur with difficult placement of an endograft, may result in endothelial damage resulting in stimulation of a procoagu-lant response.

 

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Clinical Cases in Anesthesia : Endovascular Aortic Stent Placement : What is the “post-implantation syndrome”? |


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