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A Minimally Invasive Model of Aortic Stenosis in Swine
06:51

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Published on: October 20, 2023

Anesthetic management for Wingspan stent.

Ehab Farag1, Alaa Abd-Elsayed, Michael Anderson

  • 1Departments of General Anesthesiology and Outcomes Research, Cleveland Clinic, Cleveland, OH, USA. farage@ccf.org

Ochsner Journal
|March 23, 2012
PubMed
Summary

Anesthetic management for Wingspan stent insertion in intracranial atherosclerotic disease (ICAD) poses challenges. Maintaining hemodynamic stability during stent deployment is crucial for patient safety and optimal brain perfusion.

Keywords:
Anesthetic managementWingspan stentbare metalintracranial atherosclerosisself-expandingstent

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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.