PT  - JOURNAL ARTICLE
AU  - C.E. Feliciano
AU  - R. de León-Berra
AU  - M.S. Hernández-Gaitán
AU  - H.M. Torres
AU  - O. Creagh
AU  - R. Rodríguez-Mercado
TI  - Provocative Test with Propofol: Experience in Patients with Cerebral Arteriovenous Malformations Who Underwent Neuroendovascular Procedures
AID  - 10.3174/ajnr.A1855
DP  - 2010 Mar 01
TA  - American Journal of Neuroradiology
PG  - 470--475
VI  - 31
IP  - 3
4099  - http://www.ajnr.org/content/31/3/470.short
4100  - http://www.ajnr.org/content/31/3/470.full
SO  - Am. J. Neuroradiol.2010 Mar 01; 31
AB  - 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. ACAanterior cerebral arteryACEacetylcholinesterase inhibitorAEDsantiepileptic drugsAPanteroposteriorAVMarteriovenous malformationBAbronchial asthmaBPHbenign prostatic hyperplasiaCADcoronary artery diseaseCNScentral nervous systemDMdiabetes mellitusHBPhigh blood pressureICHintracerebral hematomaIVHintraventricular hematomaMCAmiddle cerebral arteryn-BCAn-butyl cyanoacrylatePCAposterior cerebral arteryPPVpositive predictive valueSAHsubarachnoid hemorrhagesecssecondsS-MSpetzler-MartinTIAstransient ischemic attacks