破裂脳動脈瘤超急性期の脳血管造影時における血圧変動について:-持続血圧モニターによる考察-

概要

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Angiography for patients with ruptured intracranial aneurysms in ultra-acute stage is necessary for early aneurysmal surgery, but risk of rerupture during its procedure is pointed out recently. The purpose of this study is to reveal the response of systemic arterial blood pressure (SABP) during angiography and to discuss the effect of sedation or non-ionized contrast medium for SABP change to reduce the risk of rerupture of aneurysms.<BR>Seventeen patients with ruptured intracranial aneurysms were monitored their SABP by means of intra-arterial catheterization during angiography in acute stage. SABP change after injection of contrast medium of each case varied from 5 to 20% of SABP before injection. Location of aneurysms, neurological grading, interval from the last rupture of aneurysm to angiography had no relation to the degree of SABP changes. SABP changes were reduced obviously by using adequate dose of sedatives and non-ionized cotrast medium (280mgI/ml metrizamide) which is less irritative.<BR>In conclusion, adequate sedation and to use non-ionized contrast medium were useful to reduce the risk of rerupture of aneurysms during angiography in ultra-acute stage. In addition, continuous monitoring of SABP was also useful as a monitor of the general states of the patients, involving the degree of sedation, uncomforts of patients and stress of examinations.
The Japanese Society on Surgery for Cerebral Strokeの論文