Standards of anesthesiology practice during neuroradiological interventions

Abstract

Interventional radiology is a rapidly growing discipline with an expanding variety of indications and techniques in pediatric and adult patients. Accordingly, the number of procedures during which monitoring either under sedation or under general anesthesia is needed is increasing. In order to ensure high-quality care as well as patient comfort and safety, implementation of anes-thesiology practice guidelines in line with institutional radiology practice guidelines is paramount [1]. However, practice guidelines are no substitute for lack of communi-cation between specialties. Interdisciplinary indications within neurosciences call for efficient co-operation among radiology, neurology, neurosurgery, vascular surgery, anesthesiology and intensive care. Anesthesia team and intensive care personnel should be informed early and be involved in coordinated planning so that optimal results can be achieved under minimized risks and pre-arranged complication management.

Keywords: Anesthesia guidelines; Anesthesia management; Interventional neuroradiology; Standard operating procedures.

Figure 1

Unusual case of a three year old girl with an incidentally found partially thrombosed intracranial aneurysm. The girl presented with oculomotoric palsies due to small brain stem and mesencephalic (arrow) infarctions found in diffusion weighted MRI (a). Digital subtraction angiography with injection of the left vertebral artery shows the aneurysm of the right proximal posterior cerebral artery (arrow) prior (b) and after (c) endovascular occlusion with platinum coils.

Figure 2

The frequently observed jam-packed anesthesia working place in radiology department; patient monitored with NIRS.