Postoperative circulatory management following endovascular aneurysm repair: from hemodynamics to anticoagulation strategies
10.3760/cma.j.cn113855-20250405-00204
- VernacularTitle:腹主动脉瘤腔内修复术后循环管理：从血流动力学到抗凝策略
- Author:
Huibo MA
1
;
Yuehong ZHENG
1
Author Information
1. 中国医学科学院北京协和医院血管外科，北京 100730
- Publication Type:Journal Article
- Keywords:
Aortic aneurysm, abdominal;
Blood presssure;
Hemodynamics;
Fluid perfusion;
Thrombosis
- From:
Chinese Journal of General Surgery
2025;40(11):839-845
- CountryChina
- Language:Chinese
-
Abstract:
Endovascular aneurysm repair (EVAR) has increasingly replaced traditional open surgery for abdominal aortic aneurysms due to its minimally invasive adventure; however, postoperative circulatory management plays a critical role in patient outcomes. This review systematically examines three core strategies in post-EVAR care. Firstly, hemodynamic management requires precise regulation of blood pressure and cardiac output to prevent hypertension-induced stent graft migration or aneurysm sac expansion, while avoiding hypotension-related visceral hypoperfusion. Secondly, fluid balance optimization emphasizes individualized adjustment of crystalloid-to-colloid ratios through dynamic monitoring, aiming to maintain organ perfusion while protecting cardiopulmonary function. Thirdly, anticoagulation and thrombosis prevention strategies must balance the intensity of low molecular weight heparin or direct oral anticoagulants against bleeding risks, incorporating mechanical prophylaxis to further reduce thrombotic events.
