Making Endovascular Neurosurgery Safer: Role of the Neuroanesthesiologist

Abstract

The increasing use of endovascular technique for treating neurovascular diseases underscores the need for the neuroanesthesiologist to be aware of its potentially serious perioperative complications that can directly impact the anesthetic outcome. These unique complications, including intracranial thromboembolism, hemorrhage, and vasospasm, and significant non-neurological complications that necessitate deft handling by experienced anesthesiologists. However, anesthesia for endovascular neurosurgery is generally being managed in remote hospital locations by relatively junior anesthesiologists who are likely to underestimate the importance of these closed-cranium procedures. This review reacquaints the anesthetist with the periprocedural complications of endovascular neurosurgery that would enable their anticipation, prompt diagnosis, and effective management.

Keywords

• endovascular neurosurgery
• interventional neuroradiology
• neuroendovascular procedures
• anesthesia
• perioperative complications