Department of Neurosurgery, University of Iowa Hospitals and Clinics, Iowa City, IA, USA.
Department of Surgery, University of Iowa Hospitals and Clinics, Iowa City, IA, USA.
Interv Neuroradiol. 2020 Dec;26(6):767-771. doi: 10.1177/1591019920935281. Epub 2020 Jun 17.
The Woven EndoBridge (WEB) device can be used for complex intracranial aneurysms (IAs), mostly under general anesthesia (GA). However, it remains controversial if anesthetic management could affect procedural outcomes after endovascular treatments using the WEB for IAs. The purpose of this study is to investigate the safety and feasibility of the WEB deployment for patients under monitored anesthesia care (MAC).
We reviewed 27 IAs in 25 patients who were treated by using the WEB device from February to December in 2019. Our first-line anesthetic management of patients during the procedures was the MAC. GA was performed based on patient's clinical status or preference. Subjects' demographic data, aneurysms' characteristics, procedure-related complications, grade of stasis after the WEB deployment, duration of procedure, and length of hospital stay were compared between subjects who underwent GA versus those who underwent MAC.
Successful deployment of the WEB device was obtained in all patients. In total, 10 and 17 IAs were treated with GA and MAC, respectively. There was no significant difference in demographics (age: = 0.12, sex: = 0.54), aneurysms' characteristics (ruptured: = 1.00, neck width: = 0.96, aspect ratio: = 0.98, maximum diameter: = 0.69), complications ( = 1.00), postprocedural grade of stasis ( = 1.00), duration of the procedure ( = 0.23), and the length of hospital stay ( = 0.81) between GA and MAC.
MAC can be used for the WEB device deployment safely and effectively.
编织式覆膜支架(WEB)可用于复杂颅内动脉瘤(IAs)的治疗,通常在全身麻醉(GA)下进行。然而,对于使用 WEB 治疗 IAs 的血管内治疗后,麻醉管理是否会影响手术结果仍存在争议。本研究旨在探讨在监测麻醉管理(MAC)下使用 WEB 装置进行治疗的安全性和可行性。
我们回顾了 2019 年 2 月至 12 月期间 25 名患者的 27 个 IAs ,这些患者均使用 WEB 装置进行治疗。我们在手术过程中对患者的一线麻醉管理是 MAC。根据患者的临床状况或偏好进行 GA。比较 GA 组和 MAC 组患者的一般资料、动脉瘤特征、手术相关并发症、WEB 放置后的淤滞程度、手术时间和住院时间。
所有患者均成功植入 WEB 装置。总共 10 个和 17 个 IAs 分别接受 GA 和 MAC 治疗。两组患者的一般资料(年龄:=0.12,性别:=0.54)、动脉瘤特征(破裂:=1.00,颈宽:=0.96,纵横比:=0.98,最大直径:=0.69)、并发症(=1.00)、术后淤滞程度(=1.00)、手术时间(=0.23)和住院时间(=0.81)无显著差异。
MAC 可安全有效地用于 WEB 装置的植入。