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Anaesthesia for closed embolisation of cerebral arteriovenous malformations
Original Contributions
3. 4.
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bolization of cerebral vascular abnormalities. J Neurosurg Anesthesiol 1989; 1:63-‘7. Hodes JE, Fox AJ, Pelz DM, Peerless SJ: Rupture of aneurysms following balloon embolization./ Neurosurg 1990;72:567-71. Higashida RT, Halbach VV, Dowd CF, Barnwell SL, Hieshima GB: Intracranial aneurysms: interventional neurovascular treatment with detachable balloons--results in 2 15 cases. Radiology 1991;178:663-‘70. Pelz DM, Fox AJ, Vinuela F, Drake CG, Ferguson GG: Preoperative embolization of brain AVMs with isobutyl-2 cyanoacrylate. Am J Neuroradiol 1988;9:757-64. Fox AJ, Pelz DM, Lee DH: Arteriovenous malformations of the
brain: recent results of endovascular therapy. Radiology 1990; 177:51-7. 7 Vinuela F, Fox AJ: Interventional neuroradiology and the man’ agement of arteriovenous malformations and fistulas. Neural Clin 1983;1:131-54. 8. O’Mahony BJ, Bolsin SN: Anaesthesia for closed embolisation of cerebral arteriovenous malformations. Anaesth Intensive Care 1988;16:318-23. 9. Lownie SP: Clinical and technical complications of endovascular therapy in the central nervous system. Semin Intervent Radio1 1993;10:243-53.
Anaesthesia for Closed Embolisation of Cerebral Arteriovenous Malformations B.J. O’Mahony, S.N.C. B&in Department of Anaesthesia, Royal Perth Hospital, Western Australia
Abstract Cerebral arteriovenous malformation embolisation is a therapeutic, neuroradiolog ical procedure involving injection of bucrylate glue into the nidus of the AV malformation to obliterate the abnormal vascular network. These procedures may involve significant risks, are often long and thereby necessitate the need for some form of sedation and for adequate monitoring of the cerebral, cardiovascular and respiratory systems. The anaesthetic management of a series of twenty patients undergoing embolisation of a cerebral arteriovenous malformation is outlined, seven general and nineteen neurolept anaesthetics being administered. Neurolept anaesthesia is the preferred technique as neurological assessment during the procedure is possible and complications may be diagnosed immediately. Systemic arterial hypotension may facilitate the embolisation process and various agents, including glyceryl trinitrate and sodium nitroprusside, have been employed for this purpose. Reprinted
452
from Anaesthesia and Intensive Care 1988;16:318-23.
J. Clin. Anesth., vol. 7, September 1995
3. 4.
5.
6.
bolization of cerebral vascular abnormalities. J Neurosurg Anesthesiol 1989; 1:63-‘7. Hodes JE, Fox AJ, Pelz DM, Peerless SJ: Rupture of aneurysms following balloon embolization./ Neurosurg 1990;72:567-71. Higashida RT, Halbach VV, Dowd CF, Barnwell SL, Hieshima GB: Intracranial aneurysms: interventional neurovascular treatment with detachable balloons--results in 2 15 cases. Radiology 1991;178:663-‘70. Pelz DM, Fox AJ, Vinuela F, Drake CG, Ferguson GG: Preoperative embolization of brain AVMs with isobutyl-2 cyanoacrylate. Am J Neuroradiol 1988;9:757-64. Fox AJ, Pelz DM, Lee DH: Arteriovenous malformations of the
brain: recent results of endovascular therapy. Radiology 1990; 177:51-7. 7 Vinuela F, Fox AJ: Interventional neuroradiology and the man’ agement of arteriovenous malformations and fistulas. Neural Clin 1983;1:131-54. 8. O’Mahony BJ, Bolsin SN: Anaesthesia for closed embolisation of cerebral arteriovenous malformations. Anaesth Intensive Care 1988;16:318-23. 9. Lownie SP: Clinical and technical complications of endovascular therapy in the central nervous system. Semin Intervent Radio1 1993;10:243-53.
Anaesthesia for Closed Embolisation of Cerebral Arteriovenous Malformations B.J. O’Mahony, S.N.C. B&in Department of Anaesthesia, Royal Perth Hospital, Western Australia
Abstract Cerebral arteriovenous malformation embolisation is a therapeutic, neuroradiolog ical procedure involving injection of bucrylate glue into the nidus of the AV malformation to obliterate the abnormal vascular network. These procedures may involve significant risks, are often long and thereby necessitate the need for some form of sedation and for adequate monitoring of the cerebral, cardiovascular and respiratory systems. The anaesthetic management of a series of twenty patients undergoing embolisation of a cerebral arteriovenous malformation is outlined, seven general and nineteen neurolept anaesthetics being administered. Neurolept anaesthesia is the preferred technique as neurological assessment during the procedure is possible and complications may be diagnosed immediately. Systemic arterial hypotension may facilitate the embolisation process and various agents, including glyceryl trinitrate and sodium nitroprusside, have been employed for this purpose. Reprinted
452
from Anaesthesia and Intensive Care 1988;16:318-23.
J. Clin. Anesth., vol. 7, September 1995