Provocative Test with Propofol: Experience in Patients with Cerebral Arteriovenous Malformations Who Underwent Neuroendovascular Procedures
| Autor: | R. de León-Berra, O. Creagh, Caleb E Feliciano, H.M. Torres, Manuel S. Hernández-Gaitán, Rafael Rodriguez-Mercado |
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| Rok vydání: | 2009 |
| Předmět: |
Adult
Intracranial Arteriovenous Malformations Male medicine.medical_specialty Adolescent Sedation medicine.medical_treatment Diagnostic Techniques Neurological Young Adult Predictive Value of Tests Humans Hypnotics and Sedatives Medicine Radiology Nuclear Medicine and imaging Embolization Child Propofol Aged Interventional medicine.diagnostic_test business.industry Vascular disease Angiography Digital Subtraction Arteriovenous malformation Middle Aged medicine.disease Embolization Therapeutic Cerebral Angiography Surgery Injections Intra-Arterial Anesthesia Angiography Female Neurology (clinical) medicine.symptom business medicine.drug Cerebral angiography |
| Zdroj: | AJNR Am J Neuroradiol |
| ISSN: | 1936-959X 0195-6108 |
| DOI: | 10.3174/ajnr.a1855 |
| Popis: | BACKGROUND AND PURPOSE: Provocative testing before AVM embolization has been shown to be a predictor of a successful endovascular treatment without neurologic deficits. Propofol has been used previously as an alternative agent in Wada testing with adequate results. The purpose of this study was to show our experience with the use of propofol as a safe and effective alternative to barbiturate provocative testing in AVM embolization procedures. MATERIALS AND METHODS: A series of 20 patients, undergoing 38 embolization sessions, was treated for cerebral AVMs between November 2007 and February 2009 by endovascular methods. All patients were treated under conscious sedation. Pre-embolization neurologic assessment was performed with provocative testing by using propofol at 7-mg doses by an intra-arterial route after microcathether placement in or near the AVM nidus. RESULTS: Among these 20 patients, 3 developed transient neurologic deficits after provocative testing, precluding initial or further embolization. One of the patients passing the provocative test developed slight paresis as a result of embolization with n-BCA, resulting in a PPV of 97%. CONCLUSIONS: Propofol use during provocative testing in AVM embolization procedures represents an effective alternative to barbiturate testing and can have a positive impact in improving safety under sedation. |
| Databáze: | OpenAIRE |
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