当前位置： SCI文献检索 > NEUROSURGERY期刊下所有文献 > Elective stenting for intracranial stenosis under conscious sedation.

Elective stenting for intracranial stenosis under conscious sedation.

Abstract：

BACKGROUND:Elective stenting for intracranial stenosis is under study as an effective means of reducing stroke risk. At most institutions, these procedures are performed and monitored after the induction of general anesthesia. OBJECTIVE:To report our success with elective intracranial stenting and angioplasty performed in conscious patients after the administration of mild sedatives and local anesthetic agents. METHODS:We retrospectively evaluated data from 66 patients who underwent elective intracranial stenting for atherosclerosis. Sixty-one procedures were performed under local anesthesia with mild sedation; 3 were performed under general anesthesia, and 2 were converted from local to general anesthesia during the procedure. Intraprocedural neurological changes were monitored and led to reevaluation of technique, immediate reimaging, modifying the endovascular procedure itself, or possibly mandating conversion to general anesthesia. RESULTS:Thirty-nine anterior and 27 posterior circulation stenotic segments were treated. Angiographic success was achieved in 95.5% of patients with an overall reduction in stenosis of 75.5 to 22.3%. Percutaneous angioplasty and stenting were used in 58 cases; 8 patients were treated with stenting alone. Three patients (4.9%) developed neurological deficits mandating alteration or adjustment of endovascular technique or immediate postoperative management to avoid permanent sequelae. A total of 8 periprocedural complications occurred, 2 of which resulted in permanent neurological deficit. The overall mortality rate was 3.2%. CONCLUSIONS:Stenting of intracranial atherosclerosis performed under conscious sedation is associated with complication rates and effectiveness similar to historical rates for general anesthesia. Conscious sedation confers the additional benefit of continuous neurological assessment during the procedure.

journal_name

Neurosurgery

journal_title

Neurosurgery

authors

Chamczuk AJ,Ogilvy CS,Snyder KV,Ohta H,Siddiqui AH,Hopkins LN,Levy EI

doi

10.1227/NEU.0b013e3181efbcac

subject

Has Abstract

pub_date

2010-11-01 00:00:00

pages

1189-93; discussion 1194

issue

eissn

0148-396X

issn

1524-4040

journal_volume

pub_type

杂志文章

在线工具

Elective stenting for intracranial stenosis under conscious sedation.