J Cerebrovasc Endovasc Neurosurg.  2016 Sep;18(3):215-222. 10.7461/jcen.2016.18.3.215.

Procedure-related Complication Rate for the Endovascular Treatment of Aneurysmal Subarachnoid Hemorrhage under Local Anesthesia

Affiliations
  • 1Department of Neurosurgery, College of Medicine, Yeungnam University, Daegu, Korea. sofesofe@hanmail.net

Abstract


OBJECTIVE
To report the procedure related complication rate of endovascular treatments (EVTs) performed on patients with aneurysmal subarachnoid hemorrhage (aSAH) under local anesthesia (LA).
MATERIALS AND METHODS
This study enrolled 186 patients who underwent EVT for ruptured aneurysm under LA from January 2009 to December 2013. Procedure-related complications rate and factors associated with it were analyzed depending on the patients' factors, aneurysm factors and physician factors.
RESULTS
Among the 186 patients who underwent EVT under LA, the respective rates of thromboembolic complication (TEC) and intraoperative rupture (IOR) were 12.8% (23 cases) and 12.9% (24 cases), respectively. Aneurysm size (≥ 7 mm) was the only risk factor for TEC (p = 0.048).
CONCLUSION
Compared to previous result with under general anesthesia (GA), the rate of TEC was similar in patients treated under LA, but the IOR rate was significantly higher. The main reason for increasing IOR is considered as the unexpected patients' motion and in accordance with the unexpected movement of the microinstruments. Therefore, another methods to stabilize the patients or switching from LA to GA may be necessary when performing EVT, to reduce complications.

Keyword

Subarachnoid hemorrhage; Endovascular procedure; Thromboembolic complication; Intraoperative rupture; Local anesthesia

MeSH Terms

Anesthesia, General
Anesthesia, Local*
Aneurysm*
Aneurysm, Ruptured
Endovascular Procedures
Humans
Risk Factors
Rupture
Subarachnoid Hemorrhage*

Cited by  2 articles

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Jongsoo Kang, Chul-Hoo Kang, Jieun Roh, Jeong A Yeom, Dong-Hyun Shim, Young Soo Kim, Sang Won Lee, Young-Soo Kim, Kee Hong Park, Chang-Hun Kim, Soo-Kyoung Kim, Nack-Cheon Choi, Oh-Young Kwon, Heeyoung Kang, Seung Kug Baik
J Neurocrit Care. 2018;11(2):93-101.    doi: 10.18700/jnc.180059.

Should Cerebral Angiography Be Avoided within Three Hours after Subarachnoid Hemorrhage?
Hong An, Jaechan Park, Dong-Hun Kang, Wonsoo Son, Young-Sup Lee, Youngseok Kwak, Boram Ohk
J Korean Neurosurg Soc. 2019;62(5):526-535.    doi: 10.3340/jkns.2018.0238.


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