Add Intraoperative Monitoring of Penile and Buttock Blood Flow during Endovascular Abdominal Aortic Aneurysm Repair

Intraoperative-Monitoring-of-Penile-and-Buttock-Blood-Flow-during-Endovascular-Abdominal-Aortic-Aneurysm-Repair.md

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+<br>Objective: The purpose of this research was to assess the pelvic circulation throughout endovascular abdominal aortic aneurysm restore (EVAR) with a new monitoring system measuring penile and buttock blood movement. Methods: We measured penile brachial stress index (PBI) during EVAR by pulse-volume-plethysmography (kind PWV/ABItrade mark). We also measured bilateral gluteal tissue oxygen metabolism with close to-infrared spectroscopy to supply a gluteal tissue oxygenation index (TOI). Twenty-two males who underwent aortouni-iliac stentgraft with crossover bypass for exclusion of abdominal aortic aneurysm were studied. Twelve patients underwent aorto-uni-common iliac artery stentgraft (CIA) and ten underwent aorto-uni-exterior iliac artery stentgraft (EIA). Results: In all patients, there was an immediate discount in PBI in the course of the EVAR procedure. After revascularization of the ipsilateral limb of the stent graft, the restoration of PBI was considerably less in EIA group. After the completion of crossover bypass, PBI in both teams recovered to the baseline values. In each groups there was a bilateral discount in gluteal TOI during malperfusion of the internal iliac artery. After revascularization of ipsilateral limb of the stent graft, the ipsilateral TOI recovered to the baseline degree in CIA patients, but restoration was incomplete in EIA patients. In distinction, contra-lateral TOI remained low in each teams after revascularization of ipsilateral limb of the stent graft. Only after completion of crossover bypass did the contra-lateral TOI get well to baseline level in each teams. Conclusions: Both TOI on the buttocks and PBI are a sensitive reflection of pelvic haemodynamics. Penile blood movement and bilateral gluteal blood circulate are provided by way of completely different circulations and each needs to be monitored for full evaluation of the pelvic circulation.<br>
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