Anesthetic management for Wingspan stent.

Area of Science:

• Neurology
• Cardiovascular Surgery
• Anesthesiology

Background:

• The Wingspan stent, a bare metal self-expanding device, received FDA Humanitarian Device Exemption in August 2005 for treating intracranial atherosclerotic disease (ICAD) refractory to medical therapy.
• Previous reports indicated relatively low periprocedural morbidity and mortality rates associated with Wingspan stent placement.

Purpose of the Study:

• To examine the anesthetic management strategies employed.
• To evaluate the perioperative mortality and morbidity associated with Wingspan stent insertions.

Main Methods:

• A retrospective chart review was conducted after institutional review board approval.
• Data were collected for all Wingspan stent insertions performed between 2005 and 2007.

Main Results:

• 72 patients underwent angioplasty and Wingspan stent insertion for intracranial stenosis.
• The study observed a 6.9% mortality rate, 5.5% perioperative stroke rate, and 12.5% rate of recurrent stenosis.
• All patients received general anesthesia, with average preoperative systolic and diastolic blood pressures of 200 ± 45 mmHg and 100 ± 23 mmHg, respectively.

Conclusions:

• Anesthetic management for Wingspan stent insertion in ICAD is complex.
• Maintaining hemodynamic stability and ensuring optimal brain perfusion during stent deployment are critical for patient safety.
• Further prospective studies are needed to determine the optimal anesthetic approach for this procedure.