Anesthesia for interventional neuroradiology.

Therapeutic interventions unique to the neuroradiology suite include the endovascular treatment of cerebral aneurysms, arteriovenous malformations (AVM), acute thromboembolic disease, cerebral vasospasm, and extracranial and intracranial cerebrovascular atherosclerotic disease. A recent review of the National Inpatient Sample reported a doubling of the number of endovascular cases from 1993 to 2003, particularly in elderly patients. The increase in endovascular neurosurgical volume for aneurysmal cerebrovascular disease mirrors the evolution of coil technology since its initial FDA approval in the mid1990s, and reflects the increasing treatment of ruptured and unruptured aneurysms, especially when surgical clipping is thought to involve unacceptable patient risk. Endovascular treatment volumes for cerebrovascular disease will likely continue to increase as coil and stent technologies improve, the number of aged individuals with these pathologies increases, and the population comorbid disease burden contributes to net patient movement from the operating room to the endovascular suite. However, recent studies of the comparative efficacy of interventional versus medical therapy are tempering the push toward