Journals / Anestezi Dergisi / 2018 / Cilt: 26 - Sayı: 3
IS INTENSIVE CARE FOLLOW UP NECESSARY AFTER ELECTIVE ENDOVASCULAR CEREBRAL ANEURYSM TREATMENT
- Journal
- Anestezi Dergisi
- Pages
- 187–191
- DOI
- —
Abstract
Objective: Endovascular methods are frequently used in the treatment of elective unruptured intracranial aneurysms (CIA). It is frequently discussed in recent years about where patients should be monitored after the procedure. We want to investigate the need for intensive care following endovascular treatment of elective CIA patients. Method: Between February-2015 and June-2018, elective patients with unruptered intracranial aneurysms treated via endovascular method was reviewed in Baskent University. Adana Dr. Turgut Noyan Training and Research Center. Demographic information, location of aneurysms, treatments, complications, duration of stay in intensive care unit, total stay in hospital, mortality and morbidity were analyzed. Results: At the end of the investigation it was seen that 116 patients were treated endovascularly. The Male/Female ratio was 39/77. The mean age was 52.87. When the most frequently treated CIAs were examined, 27 patients (23%) were treated for left internal carotid artery aneurysm (ICA). A total of 67 patients (58%) were found to have a flow-diverter stent. Complications were observed in 10 patients, of which 4 were at the time of operation and 6 complications were after operation. Mortality or permanent morbidity was not observed. The mean intensive care stay was 1.23 days in uncomplicated cases and 7.4 days in complicated cases Conclusion: The recent debates about the follow-up of elective CIAs in intensive care have been based on reducing health care costs. But the intensive follow-ups of these patients in intensive care are very important. Today, when medicolegal issues are frequent, we advise all patients to follow intensive care in order to preserve patients and physicians and to ensure appropriate follow-up and treatment conditions.
Özet
Amaç: Elektif kanamam›fl intrakraniyal anevrizmalar›n (K‹A) tedavisinde endovasküler yöntemler s›kça kullan›lmaktad›r. ‹fllem sonras›nda hastalar›n nerede izlenmesi gerekti¤i ise son y›llarda s›kça tart›fl›lmaktad›r. Elektif K‹A hastalar›n›n takibinde yo¤un bak›m gereklili¤ini araflt›rmak istedik. Yöntem: fiubat-2015 ile Haziran-2018 y›llar› aras›nda Baflkent Üniversitesi Adana Dr. Turgut Noyan Uygulama ve Araflt›rma Merkezi’nde tedavi edilen vakalar›n, demografik bilgileri, anevrizmalar›n yerleflimleri, uygulanan tedaviler, komplikasyonlar, yo¤un bak›mda yat›fl süreleri, toplam hastanede yat›fl süreleri ve mortalite ile morbiditeleri incelendi. Bulgular: Araflt›rma sonunda 116 hastaya endovasküler olarak tedavi uyguland›¤› görüldü. Erkek/Kad›n oran› 39/77 idi. Ortalama yafl 52.87 idi. En s›k tedavi gerektiren K‹A’lar incelendi¤inde, hastalar›n 27’sinin (%23) sol internal karotid arter anevrizmas› (ICA) nedeniyle tedavi edildi¤i görüldü. Altm›fl yedi hastaya (%58) ak›m çevirici stent uyguland›¤› saptand›. On hastada komplikasyon gözlendi, bunlar›n 4’ü ifllem s›ras›nda, 6’s› ifllem sonras›nda görülen komplikasyonlard›. Mortalite veya kal›c› morbidite gözlenmedi. Komplike olmayan vakalarda ortalama yo¤un bak›m yat›fl süreleri 1.23 gün, komplikasyonla sonuçlanan vakalar›n ise ortalama yat›fl süresi ise 7.4 gün olarak saptand›. Sonuç: Son y›llarda yap›lan elektif K‹A’lar›n yo¤un bak›mda takibi ile ilgili tart›flmalar sa¤l›k giderlerini azaltmak üzerine kurulmufltur. Bu hasta grubunun yönetiminde yo¤un bak›m›n önemi çok fazlad›r. Medikolegal konular›n s›kl›kla gündeme geldi¤i günümüzde hastay› ve hekimi korumak ve uygun takip ve tedavi koflullar›n› sa¤lamak ad›na tüm hastalar›n yo¤un bak›m ünitelerinde takibini önermekteyiz.