Retrospective analysis of anesthetic management in the cerebral aneurysm treatment: Issues in the course of endovascular versus surgical treatment

Objective: To compare endovascular and surgical treatments for intracranial aneurysm in terms of anesthetic management, length of stay in the intensive care unit (ICU), morbidity, and mortality Design: Retrospective study Setting: Interventional radiology and neurosurgery operation theatre, Ankara Numune Education and Research Hospital, Ankara, Turkey Subjects: We included 143 patients who underwent endovascular or surgical management for intracranial aneurysms between January 2013 and December 2013. Interventions: Information taken from anesthesiology department database records Main outcome measures: Anesthetic agents, duration of anesthesia, controlled hypotension, invasive monitoring methods, length of stay in the post-anesthetic care unit or ICU, complications, and time to discharge were evaluated. Results: Of all patients, 54.5% (n = 78) underwent an elective procedure and the remainder 45.5% (n = 65) had emergency treatment. In most patients with subarachnoid bleeding (n = 67), surgery was performed in the early phase (n = 36; 53.7%) rather than the late phase (n = 31; 46.3%; p <0.001). Although there was no significance between the treatment groups in terms of the occurrence of vasospasm, hydrocephalus was more frequently present in the endovascular group than in the surgery group (p = 0.018). There was significant difference between the groups in terms of the time to discharge, the length of stay in the ICU, and the duration of anesthesia (p <0.005). Although more complications occurred in the surgical group patients, there was no significant difference between groups in mortality. Conclusions: In these patients, advances in endovascular techniques will enable less invasive monitoring, fewer surgical traumas and postoperative complications, and a shorter period of anesthesia.