| Anesthetic Management of Pulmonary Arterial Pressure Change during the Ethanol Sclerotherapy of Peripheral Arteriovenous Malformations. |
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Byung Seop Shin, Chung Su Kim, Byung Dal Lee, Woo Seok Sim, Jin Gu Kang, Hee Suk Kim |
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Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. csk@smcsamsung.co.kr |
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| Abstract |
BACKGROUND
We frequently experience the elevation of pulmonary arterial pressure (PAP) during ethanol sclerotherapy of arteriovenous malformations. But, the study on the degree of PAP elevation during ethanol sclerotherapy has not yet been made. Therefore, we evaluated the PAP elevation during ethanol sclerotherapy.
METHODS
We retrospectively reviewed PAP changes in 124 procedures conducted on 41 arteriovenous malformation patients during ethanol sclerotherapy. We investigated the degree of elevation of PAP and the incidences of pulmonary arterial hypertension during ethanol sclerotherapy.
RESULTS
High incidences of pulmonary arterial hypertension were observed during ethanol sclerotherapy (53/124 procedures, 42.7%). The mean highest PAP values were 33.8 +/- 10.9 mmHg (systolic), 25.2 +/- 7.9 mmHg (mean), and 18.3 +/- 7.4 mmHg (diastolic). Incidence of nitroglycerine administration was 47.5% (59/124 procedures). Mean PAP values at the end of procedure was 29.1 +/- 9.1 mmHg (systolic), 22.0 +/- 7.0 mmHg (mean), and 16.1 +/- 6.4 mmHg (diastolic).
Conclusion
The incidences of pulmonary hypertension during ethanol sclerotherapy were high. Therefore, cautious management and close cooperation between anesthesiologist and interventional radiologist are essential to prevent dreadful outcome. |
| Key Words:
alcohol; pulmonary hypertension; sclerotherapy |
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