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Interventional neuroradiology. Recent developments and anaesthesiologic aspects
1Department for Anaesthesia and Intensive Care, Inselspital, University of Berne, Switzerland. martin.luginbuehl@dkf 2.unibe.ch
Minerva Anestesiologica
|July 8, 1999
Summary
Interventional neuroradiology (INR) introduces new treatments like coil embolization for aneurysms and thrombolysis for stroke. Anesthesiologists play a key role in patient monitoring and managing complications during these procedures.
Area of Science:
- Interventional Neuroradiology
- Neuroanesthesia
Background:
- Interventional neuroradiology (INR) has seen significant advancements.
- These advancements necessitate a discussion of associated anesthesiologic considerations.
Purpose of the Study:
- To summarize recent developments in interventional neuroradiology.
- To discuss the anesthetic considerations for these interventional procedures.
Main Methods:
- Review of recent developments in interventional neuroradiology.
- Discussion of anesthetic management strategies for INR procedures.
Main Results:
- New procedures include cerebral aneurysm embolization with Guglielmi detachable coils (GDC), intra-arterial thrombolysis, and angioplasty for acute ischemic stroke and chronic cerebral artery stenosis.
- Established procedures include embolization of vascular neoplasms, arteriovenous malformations/fistulas, and angioplasty for vasospasms; diagnostic tests like the balloon occlusion and WADA tests are also common.
- Anesthesiologist's role involves analgesia, sedation, monitoring, maintaining vital functions, and managing heparinization, with decisions based on patient condition and procedure type.
Conclusions:
- Most INR procedures can be safely performed under light sedation, allowing continuous neurological assessment.
- Close collaboration between anesthesiologists and neuroradiologists is crucial for managing potential hemorrhagic or ischemic complications (1-8% incidence).
- Experienced anesthesia staff is required for prompt management of emergencies during INR procedures.