Neurointerventional procedures for unruptured intracranial aneurysms under procedural sedation and local anesthesia: a large-volume, single-center experience

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In this paper, the authors' goal was to report the outcome of patients with unruptured intracranial aneurysms undergoing endovascular treatment under conscious sedation (local anesthesia).


Between November 5, 2001, and February 5, 2009, the authors treated 340 patients with 358 unruptured aneurysms by using neurointerventional procedures at Millard Fillmore Gates Hospital (Buffalo, New York). The data were retrospectively reviewed for periprocedural safety and long-term follow-up.


A total of 496 procedures were performed under local anesthesia. Of those, 370 procedures (74.6%) were completed successfully. In 82 procedures (16.5%), an associated medical or technical event occurred. Forty-four procedures (8.9%) were aborted. Rates of overall procedure-related morbidity and mortality were 1.2% (6 of 496) and 0.6% (3 of 496), respectively. The average hospital stay was 1.5 ± 2.5 days. Long-term follow-up was available in 261 (82.1%) of 318 patients whose procedures were performed with local anesthesia. Of those, 246 patients (94.3%) had a good outcome (modified Rankin Scale score ≤ 2), 6 patients (2.3%) had an unfavorable outcome, not related to the procedure, and 9 patients (3.4%) had a poor outcome (modified Rankin Scale score > 2) as a result of the intervention.


Interventional treatment under conscious sedation (local anesthesia) can be effectively performed in most patients with unruptured intracranial aneurysms and is associated with a short hospital stay and low morbidity and mortality.

Abbreviations used in this paper: CN = cranial nerve; ICU = intensive care unit; LOS = length of stay; mRS = modified Rankin Scale; TIA = transient ischemic attack.

Article Information

Address correspondence to: Christopher S. Ogilvy, M.D., Wang Ambulatory Care Center–ACC-745, Neurosurgical Service, Massachusetts General Hospital, Parkman Street, Boston, Massachusetts 02114. email:

Please include this information when citing this paper: published online April 16, 2010; DOI: 10.3171/2010.3.JNS091384.

© AANS, except where prohibited by US copyright law.



  • View in gallery

    Graph showing yearly numbers of interventional procedures performed for unruptured intracranial aneurysms under local and general anesthesia (Anes).

  • View in gallery

    Graph showing yearly numbers of patients and aneurysms treated by interventional methods.



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