Anaesthesia for abdominal vascular surgery

Although there are a number of abdominal pathologies requiring vascular surgical intervention, aortic aneurysmal disease is by far the most common and the focus of this article. The most obvious development in this area has been the implementation of a national screening programme for abdominal aortic aneurysm (AAA). Recent changes to try and improve elective mortality figures from around 8% for open repair have been essential to make the screening programme effective. Endovascular aneurysm repair (EVAR) is now the most common technique for elective management. Longer term risks and benefits of endovascular versus open repair is still an area of some controversy. Also controversial is the role of endovascular repair in the emergency ruptured setting. In this article we give an overview of all these areas as well as reviewing current indications for aortic aneurysm surgery. We also include an update of anaesthetic best practices for these patients.