Immediate Anesthesia Management Of Complications During Embolization Of Cerebral Vascular Lesions

Abstract

Interventional neuroradiology (INR) can provide treatments for central nervous system (CNS) diseases, especially for intracranial vascular lesions by endovascular access in order to deliver therapeutic agents, including both drugs and devices. The procedures can be lengthy and uncomfortable and patients require sedation or anesthesia in addition to continuous monitoring of the cardiorespiratory and neurologic systems. The anesthetic management, the occurrence and the treatment of complications are reviewed in 101 patients who underwent a total of 121 INR procedures. Under general endotracheal anesthesia a superselective microcatheter was introduced into the cerebral circulation via the femoral artery. The coaxial catheter was advanced into the lesion with fluroscopic guidance and used to deliver embolic materials into the lesion. Charts were reviewed for information regarding the anesthetic management, monitoring technique, intraoperative complications and the anesthetic intervention. There were documented 22 episodes of anesthetic or radiological technique-related complications. Anesthesia was involved in 7 cases and 15 complications were directly related to the INR.