Purpose: The purpose of our study was to investigate the frequency of hemodynamic instability in patients undergoing carotid artery stenting (CAS) under general anesthesia using sevoflurane and nitrous oxide in oxygen.
Methods: A total of 97 consecutive CAS procedures were performed in 84 patients under sevoflurane anesthesia. The following hemodynamic variables were assessed: degree of systolic blood pressure change (deltaSBP) during CAS, hypotension, and bradycardia during and after CAS.
Results: During CAS, hypotension occurred in 43% of the patients, and bradycardia occurred in 14%. There was individual variation in the deltaSBP during CAS. Systolic blood pressure (SBP) change >50 mmHg was not seen in this series. After CAS, hypotension occurred in 24%, and bradycardia occurred in 10%. Cerebral infarction occurred in three cases. The stroke rate was 3.1% in this series.
Conclusion: General anesthesia using sevoflurane and nitrous oxide in oxygen depressed barorecepter reflex sensitivity, induced hemodynamic stability under CAS, and may decrease the rate of occurrence of complications.
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Diagn Interv Radiol
December 2024
Ege University Faculty of Medicine, Department of Interventional Radiology, İzmir, Türkiye.
Purpose: This study aims to investigate the indications and therapeutic efficacy of flow-diverting stents (FDSs) in the management of extracranial carotid artery aneurysms (ECAAs) and dissections.
Methods: A retrospective analysis was conducted on 18 patients treated for ECAAs with an FDS between 2010 and 2024. Patient demographics, aneurysm characteristics, procedural details, and clinical and radiologic follow-up outcomes were extracted from medical records.
J West Afr Coll Surg
August 2024
Department of Anaesthesia, University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu, Nigeria.
Background: Considerable morbidity is attributable to inappropriate tracheal cuff pressure. An earlier study undertaken in our hospital revealed that a normal cuff pressure of 20-30 cm HO was achieved in only 6% of intubated patients using subjective estimation methods.
Objective: To determine whether a training intervention could improve the accuracy of the subjective estimation method in our tracheal cuff monitoring.
Cureus
November 2024
Cardiovascular Surgery, Sapporo Medical University, Sapporo, JPN.
The patient an 85-year-old female resided in a care facility where she maintained an independent daily activity level. She was discovered hunched over a table in her room, displaying reduced responsiveness and prompting an emergency call. Initially, her blood pressure was within 60 mmHg, and she was transported by ambulance to our hospital.
View Article and Find Full Text PDFCureus
November 2024
Department of General Surgery, University of Virginia, Charlottesville, USA.
In this case report, we discuss the critical interdependence of structure and function in demonstrating systolic anterior motion (SAM) of the mitral valve after repeat heart transplantation, where residual apical tissue of the explanted heart remained in place. The resulting conformational changes led to anterior displacement of the mitral valve and persistent SAM.
View Article and Find Full Text PDFCureus
November 2024
Anesthesiology and Critical Care, Kindai University Faculty of Medicine, Osaka, JPN.
Background: Epiglottic masses are often asymptomatic, making them difficult to detect during preoperative examinations. Consequently, anesthesiologists may face ventilation difficulties with no apparent cause. Epiglottic masses can sometimes obstruct laryngoscope insertion into the epiglottic vallecula, complicating general anesthesia induction.
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