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Patients undergo manipulation of an often calcified aorta near the origin of the carotid and subclavian vessels and have stents placed in a curved vessel adjacent to a perpetually beating heart. These stents can obstruct blood flow to the spinal cord, induce an inflammatory response, and in rare cases erode into the adjacent trachea or esophagus. Renal complications range from contrast-induced nephropathy to hypotension and ischemia to dissection. Emboli can lead to strokes and mesenteric ischemia. These patients have complex medical histories, and skilled perioperative management is critical to achieving the best clinical outcomes. Here, we review the medical management of the most common complications in these patients including stroke, spinal cord ischemia, renal injury, retrograde dissections, aortoesophageal and aortobronchial fistulas, postimplantation syndrome, mesenteric ischemia, and endograft failure.<\/jats:p>","DOI":"10.1177\/0885066617730571","type":"journal-article","created":{"date-parts":[[2017,9,25]],"date-time":"2017-09-25T22:42:41Z","timestamp":1506379361000},"page":"394-406","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":24,"title":["Complications and Perioperative Management of Patients Undergoing Thoracic Endovascular Aortic Repair"],"prefix":"10.1177","volume":"33","author":[{"given":"Anna P.","family":"Sattah","sequence":"first","affiliation":[{"name":"School of Arts and Sciences, Duke University, Durham, NC, USA"},{"name":"School of Medicine and Department of Surgery, University of Virginia, Charlottesville, VA, USA"},{"name":"Department of Anesthesia and Critical Care, George Washington University Medical Center, Washington, DC, USA"},{"name":"Holy Cross Hospital, Silver Spring, MD, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael H.","family":"Secrist","sequence":"additional","affiliation":[{"name":"College of Humanities, Brigham Young University, Provo, UT, USA"},{"name":"Doctor of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA"},{"name":"Department of Interventional Radiology, University of California, Irvine, CA, USA"},{"name":"Department of Radiology, George Washington University Medical Center, Washington, DC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shawn","family":"Sarin","sequence":"additional","affiliation":[{"name":"School of Medicine and Department of Surgery, University of Virginia, Charlottesville, VA, USA"},{"name":"Kasturba Medical College, Karnataka, India"},{"name":"Northeast Ohio Medical Universities, 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