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Minim Invasive Neurosurg 2000; 43(2): 102-105
DOI: 10.1055/s-2000-8327
ÜBERSICHT
Georg Thieme Verlag Stuttgart · New York

Anaesthesiological and Criterial Care Aspects Regarding the Treatment of Patients with Arteriovenous Malformations in Interventional Neuroradiology

K. Jaeger1 , H. Ruschulte1 , T. Herzog2 , J. Heine1 , M. Leuwer1 , S. Piepenbrock1
  • 1 Department of Anaesthesiology, Hannover Medical School, Hannover, Germany
  • 2 Department of Neuroradiology, Hannover Medical School, Hannover, Germany
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Publication History

Publication Date:
31 December 2000 (online)

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In recent years, the neuroradiological treatment of cerebral and spinal arteriovenous malformations (AVMs) has undergone significant evolution and improvement. Endovascular embolisation procedures of AVMs are mainly performed under general anaesthesia. Different pathophysiological characteristics of patients with AMVs must be considered for the choice of the anaesthetic procedures. Anaesthesiological management must aim at maintaining stable intracranial haemodynamics; thus, the drugs used must be evaluated according to their effects on brain perfusion, brain metabolism, and intracranial pressure. Rapid recovery to normal central nervous functions should be obtained postoperatively. Close-meshed neurological surveillance should be exercised in order to detect immediately any alteration of neurological state. In summary, anaesthesiological management of interventional neuroradiology is based on the same well-established principles as anaesthesia in neurosurgery.

Key words:

Anaesthesia, General - Anaesthesia, Local - Cerebral Arteriovenous Malformations - Conscious Sedation - Embolisation, Therapeutic - Intensive Care - Radiology, Interventional

References

  • 1 Piepgras D G, Sundt Jr T M, Ragoowansi A T, Stevens L. Seizure outcome in patients with surgically treated cerebral arteriovenous malformations.  J Neurosurg. 1993;  78 5-11
    CrossrefPubMedGoogle Scholar
  • 2 Friedman W A, Bova F J. Linear accelerator radiosurgery for arteriovenous malformations.  J Neurosurg. 1992;  77 832-841
    CrossrefPubMedGoogle Scholar
  • 3 Spetzler R F, Martin N A. A proposed grading system for arteriovenous malformations.  J Neurosurg. 1986;  65 476-483
    Google Scholar
  • 4 Lasjaunias P, Hui F, Zerah M, Garcia Monaco R, Malherbe V, Rodesch G, Tanaka A, Alvarez H. Cerebral arteriovenous malformations in children. Management of 179 consecutive cases and review of the literature.  Childs Nerv Syst. 1995;  11 66-79
    CrossrefPubMedGoogle Scholar
  • 5 Rodesch G, Malherbe V, Alvarez H, Zerah M, Devictor D, Lasjaunias P. Nongalenic cerebral arteriovenous malformations in neonates and infants. Review of 26 consecutive cases (1982 - 1992).  Childs Nerv Syst. 1995;  11 231-241
    CrossrefPubMedGoogle Scholar
  • 6 Foo K L, Woo M. Anaesthesia for closed embolisation of cerebral arteriovenous malformations.  Med J Malaya. 1992;  47 31-37
    PubMedGoogle Scholar
  • 7 O'Mahony B J, Bolsin S N. Anaesthesia for closed embolisation of cerebral arteriovenous malformations.  Anaesth Intensive Care. 1988;  16 318-323
    PubMedGoogle Scholar
  • 8 Manninen P H, Gignac E M, Gelb A W, Lownie S P. Anesthesia for interventional neuroradiology.  J Clin Anesth. 1995;  7 448-452
    CrossrefPubMedGoogle Scholar
  • 9 Young W L, Pile Spellman J. Anesthetic considerations for interventional neuroradiology.  Anesthesiology. 1994;  80 427-456
    PubMedGoogle Scholar
  • 10 Purdy P D, Batjer H H, Samson D. Management of hemorrhagic complications from preoperative embolization of arteriovenous malformations.  J Neurosurg. 1991;  74 205-211
    PubMedGoogle Scholar
  • 11 Young W L, Kader A, Ornstein E, Baker K Z, Ostapkovich N, Pile Spellman J, Fogarty Mack P, Stein B M. Cerebral hyperemia after arteriovenous malformation resection is related to ”breakthrough” complications but not to feeding artery pressure. The Columbia University Arteriovenous Malformation Study Project.  Neurosurgery. 1996;  38 1085-1093
    CrossrefPubMedGoogle Scholar
  • 12 Carapiet D A, Stevens J E. Pulmonary embolism following embolization of an arteriovenous malformation.  Paediatr Anaesth. 1996;  6 491-494
    PubMedGoogle Scholar
  • 13 Ring J, Rothenberger K H, Clauss W. Prevention of anaphylactoid reactions after radiographic contrast media infusion by combined histamine H1- and H2-receptor antagonists: results of a prospective controlled trial.  Int Arch Allergy Appl Immunol. 1985;  78 9-14
    PubMedGoogle Scholar
  • 14 Müller-Forell W, Valavanis A. How angioarchitecture of cerebral arteriovenous malformations should influence the therapeutic considerations.  Minim Invasive Neurosurg. 1995;  38 32-40
    PubMedGoogle Scholar
  • 15 Millar C, Bissonnette B, Humphreys R P. Cerebral arteriovenous malformations in children.  Can J Anaesth. 1994;  41 321-331
    PubMedGoogle Scholar
  • 16 Bouvaist H, Rossignol A M, Rocca C, Andrini P, Durand C, Bost M. Aneurysm of the vein of Galen and cardiac insufficiency. Current therapeutic approach.  Arch Mal Coeur Vaiss. 1998;  91 637-643
    PubMedGoogle Scholar
  • 17 Geri A, Graziano D V, Gifuni D, Ruggiero R, Bandieramonte G, Ruggiero C, Ruggiero A. Anesthesia in the diagnostic stages of cerebral arteriovenous malformations in children under 3 years of age.  Agressologie. 1990;  31 284-286
    PubMedGoogle Scholar
  • 18 Panning B, Piepenbrock S. Anaesthetic management during invasive and non-invasive neuroradiologic procedures.  Curr Opin Anaesth. 1991;  4 645-648
    PubMedGoogle Scholar
  • 19 Hiew C Y, Hart G K, Thomson K R, Hennessy O F. Analgesia and sedation in interventional radiological procedures.  Australas Radiol. 1995;  39 128-134
    PubMedGoogle Scholar
  • 20 Panning B, Piepenbrock S. Anesthesia during neuroradiology.  Hiroshima J Anesth. 1992;  28 153-157
    PubMedGoogle Scholar
  • 21 Hoffman W E, Charbel F T, Edelman G, Abood C. Brain tissue response to CO2 in patients with arteriovenous malformation.  J Cereb Blood Flow Metab. 1996;  16 1383-1386
    PubMedGoogle Scholar
  • 22 Hoffman W E, Charbel F T, Edelman G, Ausman J I. Brain tissue oxygenation in patients with cerebral occlusive disease and arteriovenous malformations.  Br J Anaesth. 1997;  78 169-171
    PubMedGoogle Scholar

Corresponding Author:

Dr. med K Jaeger

Zentrum Anästhesiologie Medizinische Hochschule Hannover

Carl-Neuberg-Straße 1 30625 Hannover Germany

Phone: Phone:++49-511-532/3561

Fax: Fax:++49-511-532/5649

Email: E-mail: jaeger.karsten@mh-hannover.de

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