The Role of Continuous Blood Pressure Monitoring During Angiography for Patients with Ruptured Aneurysms in Ultra-acute Stage

Abstract

Angiography for patients with ruptured intracranial aneurysms in ultra-acute stage is necessary for early aneurysmal surgery, but risk of rerupture during its procedure is pointed out recently. The purpose of this study is to reveal the response of systemic arterial blood pressure (SABP) during angiography and to discuss the effect of sedation or non-ionized contrast medium for SABP change to reduce the risk of rerupture of aneurysms.
Seventeen patients with ruptured intracranial aneurysms were monitored their SABP by means of intra-arterial catheterization during angiography in acute stage. SABP change after injection of contrast medium of each case varied from 5 to 20% of SABP before injection. Location of aneurysms, neurological grading, interval from the last rupture of aneurysm to angiography had no relation to the degree of SABP changes. SABP changes were reduced obviously by using adequate dose of sedatives and non-ionized cotrast medium (280mgI/ml metrizamide) which is less irritative.
In conclusion, adequate sedation and to use non-ionized contrast medium were useful to reduce the risk of rerupture of aneurysms during angiography in ultra-acute stage. In addition, continuous monitoring of SABP was also useful as a monitor of the general states of the patients, involving the degree of sedation, uncomforts of patients and stress of examinations.