Kundishora Adam J, Englot Dario J, Starr Philip A, Martin Alastair J, Larson Paul S
Department of Neurosurgery, Yale University School of Medicine, New Haven, Connecticut, USA.
Department of Neurological Surgery, University of California, San Francisco, California, USA.
Stereotact Funct Neurosurg. 2018;96(1):40-45. doi: 10.1159/000486642. Epub 2018 Mar 1.
BACKGROUND/AIMS: Interventional MRI (iMRI) allows real-time confirmation of electrode and microcatheter location in anesthetized patients; however, MRI-compatible pneumatic compression devices (PCD) to reduce the periprocedural venous thromboembolism (VTE) risk are not commercially available. Given the paucity of literature on VTE following iMRI surgery, better characterizing patients suffering this complication and the incidence of this event following iMRI procedures is pivotal for defining best surgical practices. We aim to investigate the incidence of postoperative VTE in iMRI procedures without the use of PCD.
Medical records and operative times of patients were retrospectively reviewed. Patient demographics and mean surgical durations were reported with statistical comparisons via ANOVA and the 2-tailed Student t test, an α of 0.05, and the Bonferroni correction. Patients experiencing postoperative VTE underwent an in-depth chart review.
Two out of two hundred ten (0.95%) iMRI procedures resulted in postoperative VTE events. There were statistically significant differences in procedure times between unilateral electrode (157.5 ± 5.7 min), bilateral electrode (193.6 ± 2.9 min), and bilateral gene therapy procedures (467.3 ± 26.5 min). Both patients had longer-than-average operative times for their respective procedures.
The incidence of postoperative VTE is low following iMRI procedures, even without the use of PCD during surgery.
背景/目的：介入性磁共振成像（iMRI）可在麻醉患者中实时确认电极和微导管的位置；然而，用于降低围手术期静脉血栓栓塞（VTE）风险的磁共振成像兼容气动压缩装置（PCD）尚无商业产品。鉴于关于iMRI手术后VTE的文献较少，更好地描述发生这种并发症的患者情况以及iMRI手术后该事件的发生率对于确定最佳手术操作至关重要。我们旨在调查在不使用PCD的情况下iMRI手术中术后VTE的发生率。
对患者的病历和手术时间进行回顾性分析。通过方差分析和双侧Student t检验报告患者人口统计学数据和平均手术时长，并进行统计学比较，α值为0.05，并采用Bonferroni校正。对发生术后VTE的患者进行深入的病历审查。
210例iMRI手术中有2例（0.95%）发生术后VTE事件。单侧电极手术（157.5±5.7分钟）、双侧电极手术（193.6±2.9分钟）和双侧基因治疗手术（467.3±26.5分钟）的手术时间存在统计学显著差异。两名患者各自手术的手术时间均长于平均水平。
即使在手术期间不使用PCD，iMRI手术后术后VTE的发生率也较低。
