Provocative Test with Propofol: Experience in Patients with Cerebral Arteriovenous Malformations Who Underwent Neuroendovascular Procedures
Open Access
- 5 November 2009
- journal article
- research article
- Published by American Society of Neuroradiology (ASNR) in American Journal of Neuroradiology
- Vol. 31 (3), 470-475
- https://doi.org/10.3174/ajnr.a1855
Abstract
BACKGROUND AND PURPOSE: Provocative testing before AVM embolization has been shown to be a predictor of a successful endovascular treatment without neurologic deficits. Propofol has been used previously as an alternative agent in Wada testing with adequate results. The purpose of this study was to show our experience with the use of propofol as a safe and effective alternative to barbiturate provocative testing in AVM embolization procedures. MATERIALS AND METHODS: A series of 20 patients, undergoing 38 embolization sessions, was treated for cerebral AVMs between November 2007 and February 2009 by endovascular methods. All patients were treated under conscious sedation. Pre-embolization neurologic assessment was performed with provocative testing by using propofol at 7-mg doses by an intra-arterial route after microcathether placement in or near the AVM nidus. RESULTS: Among these 20 patients, 3 developed transient neurologic deficits after provocative testing, precluding initial or further embolization. One of the patients passing the provocative test developed slight paresis as a result of embolization with n-BCA, resulting in a PPV of 97%. CONCLUSIONS: Propofol use during provocative testing in AVM embolization procedures represents an effective alternative to barbiturate testing and can have a positive impact in improving safety under sedation.Keywords
This publication has 12 references indexed in Scilit:
- Can pentobarbital replace amobarbital in the Wada test?Epilepsy & Behavior, 2007
- Has amobarbital expired?Neurology, 2005
- Etomidate speech and memory test ( e SAM)Neurology, 2005
- Evaluation of adverse effects in intracarotid propofol injection for Wada testNeurology, 2005
- Risk factors of relative adrenocortical deficiency in intensive care patients needing mechanical ventilationIntensive Care Medicine, 2005
- Sodium Methohexital (Brevital) as an Anesthetic in the Wada TestEpilepsia, 2002
- The Wada test with propofol in a patient with epilepsyArquivos de Neuro-Psiquiatria, 2000
- The Endovascular Treatment of Brain Arteriovenous MalformationsAdvances and Technical Standards in Neurosurgery, 1998
- Deep central arteriovenous malformations of the brain: the role of endovascular treatmentJournal of Neurosurgery, 1995
- Endovascular treatment of intracerebral arteriovenous malformations: experience in 49 casesJournal of Neurosurgery, 1991