Korean J Anesthesiol.  1998 Dec;35(6):1161-1168. 10.4097/kjae.1998.35.6.1161.

The Hemodynamic Changes of Alcohol Sclerotherapy in Patients with Congenital Peripheral Arteriovenous Malformation

• Gwak MS
• Cho HS
• Kim YH
• Kim SJ
• Kim JA
• Lee SM
• Chung IS

• KMID: 2237635
• DOI: http://doi.org/10.4097/kjae.1998.35.6.1161

Abstract

BACKGROUND: Arteriovenous malformations (AVMs) are increasingly treated by radiologists using various embolic materials. Because of pain and significant hemodynamic changes that may be associated with this treatment, anesthesiologists are frequently asked to provide anesthesia and supportive care. We evaluated the hemodynamic changes that occurred after absolute alcohol embolization.
METHODS
Fourteen patients between 15 and 50 years of age who had arteriovenous malformation were included in this study. 2 to 4 ml of alcohol was injected each time. The hemodynamic parameters were measured before alcohol injection (control) and after 1st to 10th alcohol injection.
RESULTS
Blood pressure, heart rate, and cardiac output were significantly increased after 1st to 10th alcohol injection compared with control value. Central venous pressure, pulmonary capillary wedge pressure and systemic vascular resistance were not significantly changed. But pulmonary vascular resistance was significantly increased after 9th and 10th alcohol injection. Systolic pulmonary artery pressure was significantly increased after 4th, 8th, 9th and 10th alcohol injection.
CONCLUSIONS
Bolus injection of absolute ethyl alcohol induces short-term significant increases in blood pressure, heart rate and cardiac output probably by severe pain and sympathetic activation that appear to be centrally mediated. The underlying mechanism of cardiovascular event and other systemic effects of intravascular ethanol in this setting need further study.

Keyword

Blood vessel, arteriovenous malformations; Monitoring, hemodynamics; Pharmacology, ethyl alcohol

MeSH Terms

Anesthesia
Arteriovenous Malformations*
Blood Pressure
Cardiac Output
Central Venous Pressure
Ethanol
Heart Rate
Hemodynamics*
Humans
Pulmonary Artery
Pulmonary Wedge Pressure
Sclerotherapy*
Vascular Resistance
Ethanol