Clinical Results of Flow Diverter Treatments for Cerebral Aneurysms under Local Anesthesia

Flow diverters (FD) have become the mainstay for the endovascular treatment of unruptured intracranial aneurysms (UIA). Most FD procedures are performed under general anesthesia, and the influence of local anesthesia (LA) on outcomes remains unknown. This study evaluated the results of FD placement...

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Main Authors: Saujanya Rajbhandari, Hidetoshi Matsukawa, Kazutaka Uchida, Manabu Shirakawa, Shinichi Yoshimura
Format: Article
Language:English
Published: MDPI AG 2022-08-01
Series:Brain Sciences
Subjects:
Online Access:https://www.mdpi.com/2076-3425/12/8/1076
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author Saujanya Rajbhandari
Hidetoshi Matsukawa
Kazutaka Uchida
Manabu Shirakawa
Shinichi Yoshimura
author_facet Saujanya Rajbhandari
Hidetoshi Matsukawa
Kazutaka Uchida
Manabu Shirakawa
Shinichi Yoshimura
author_sort Saujanya Rajbhandari
collection DOAJ
description Flow diverters (FD) have become the mainstay for the endovascular treatment of unruptured intracranial aneurysms (UIA). Most FD procedures are performed under general anesthesia, and the influence of local anesthesia (LA) on outcomes remains unknown. This study evaluated the results of FD placement under LA. Data of patients treated for FD under LA between August 2016 and January 2022 were analyzed retrospectively. A good outcome was defined as a modified Rankin scale score of 0–2. Major stroke, steno-occlusive events of FD, mortality, and satisfactory aneurysm occlusion were also evaluated. In total, 169 patients undertook 182 treatments (139 [82%) female, mean age 61 ± 11 years). The median maximum aneurysm size was 9.5 mm (interquartile range 6.1-14 mm). A flow re-directed endoluminal device and pipeline embolization device were used in 103 (57%) and 78 (43%) treatments. One patient (0.59%) experienced major stroke, and steno-occlusive events were observed in four patients (2.4%). A good outcome at 90 days was obtained in 164 patients (98%), and one patient died (0.59% mortality). During the median follow-up period of 345 days (interquartile range 176–366 days), satisfactory aneurysm occlusion was observed in 126 of 160 aneurysms (79%). Our results suggest that FD placement under LA is a safe and effective treatment for UIA.
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spelling doaj.art-d7448ac66c2d42bbae0b429d05ba60bb2023-11-30T23:18:23ZengMDPI AGBrain Sciences2076-34252022-08-01128107610.3390/brainsci12081076Clinical Results of Flow Diverter Treatments for Cerebral Aneurysms under Local AnesthesiaSaujanya Rajbhandari0Hidetoshi Matsukawa1Kazutaka Uchida2Manabu Shirakawa3Shinichi Yoshimura4Department of Neurosurgery, Hyogo College of Medicine, Nishinomiya 663-8501, Hyogo, JapanDepartment of Neurosurgery, Takarazuka City Hospital, Takarazuka 665-0827, Hyogo, JapanDepartment of Neurosurgery, Hyogo College of Medicine, Nishinomiya 663-8501, Hyogo, JapanDepartment of Neurosurgery, Hyogo College of Medicine, Nishinomiya 663-8501, Hyogo, JapanDepartment of Neurosurgery, Hyogo College of Medicine, Nishinomiya 663-8501, Hyogo, JapanFlow diverters (FD) have become the mainstay for the endovascular treatment of unruptured intracranial aneurysms (UIA). Most FD procedures are performed under general anesthesia, and the influence of local anesthesia (LA) on outcomes remains unknown. This study evaluated the results of FD placement under LA. Data of patients treated for FD under LA between August 2016 and January 2022 were analyzed retrospectively. A good outcome was defined as a modified Rankin scale score of 0–2. Major stroke, steno-occlusive events of FD, mortality, and satisfactory aneurysm occlusion were also evaluated. In total, 169 patients undertook 182 treatments (139 [82%) female, mean age 61 ± 11 years). The median maximum aneurysm size was 9.5 mm (interquartile range 6.1-14 mm). A flow re-directed endoluminal device and pipeline embolization device were used in 103 (57%) and 78 (43%) treatments. One patient (0.59%) experienced major stroke, and steno-occlusive events were observed in four patients (2.4%). A good outcome at 90 days was obtained in 164 patients (98%), and one patient died (0.59% mortality). During the median follow-up period of 345 days (interquartile range 176–366 days), satisfactory aneurysm occlusion was observed in 126 of 160 aneurysms (79%). Our results suggest that FD placement under LA is a safe and effective treatment for UIA.https://www.mdpi.com/2076-3425/12/8/1076anesthesiacerebral aneurysmflow diverteroutcome
spellingShingle Saujanya Rajbhandari
Hidetoshi Matsukawa
Kazutaka Uchida
Manabu Shirakawa
Shinichi Yoshimura
Clinical Results of Flow Diverter Treatments for Cerebral Aneurysms under Local Anesthesia
Brain Sciences
anesthesia
cerebral aneurysm
flow diverter
outcome
title Clinical Results of Flow Diverter Treatments for Cerebral Aneurysms under Local Anesthesia
title_full Clinical Results of Flow Diverter Treatments for Cerebral Aneurysms under Local Anesthesia
title_fullStr Clinical Results of Flow Diverter Treatments for Cerebral Aneurysms under Local Anesthesia
title_full_unstemmed Clinical Results of Flow Diverter Treatments for Cerebral Aneurysms under Local Anesthesia
title_short Clinical Results of Flow Diverter Treatments for Cerebral Aneurysms under Local Anesthesia
title_sort clinical results of flow diverter treatments for cerebral aneurysms under local anesthesia
topic anesthesia
cerebral aneurysm
flow diverter
outcome
url https://www.mdpi.com/2076-3425/12/8/1076
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