• Longhui Zhang, Chao Wang, Xuefang Wu, Xinzhi Wu, Yisen Zhang, Jian Liu, Baixue Jia, Haoyu Zhu, Zhongrong Miao, Fangguang Chen, Yun Wang, Qinggui Jiao, Ying Zhang, and Ming Lv.
• Departments of1Interventional Neuroradiology and.
• J. Neurosurg. 2024 Aug 9: 1101-10.

ObjectivePipeline embolization device (PED) placement for the treatment of intracranial aneurysms is safe and effective under general anesthesia (GA). However, GA is associated with certain risks, longer procedural time, and higher hospital cost. The authors aimed to compare clinical outcomes and hospital cost between GA and local anesthesia (LA) procedures in patients who underwent PED placement for intracranial aneurysm treatment.MethodsThis retrospective study analyzed the charts of 216 patients with 223 intracranial aneurysms treated using the PED from June 2022 to March 2023. Cases were grouped according to type of anesthesia administered (LA or GA). Propensity score matching (PSM) was used to balance the groups to minimize confounding bias.ResultsEighty-four patients with 88 aneurysms were treated under LA, and 132 patients with 135 aneurysms were treated under GA. The complication rate and modified Rankin Scale score at 6 months were similar in both groups. Procedural time was significantly shorter with LA both before (87.47 ± 22.68 minutes vs 118.90 ± 46.80 minutes, p < 0.001) and after (84.75 ± 16.77 minutes vs 110.02 ± 38.56 minutes, p < 0.001) PSM. LA eliminates the need for postanesthesia recovery. Hospital cost was significantly lower in the LA group both before ($30,820.74 ± $3216.93 vs $32,846.62 ± $4731.50, p = 0.001) and after ($30,127.83 ± $2763.12 vs $33,874.41 ± $3163.56, p = 0.002) PSM.ConclusionsPED placement under LA can achieve satisfactory outcomes similar to those of PED placement under GA; however, the use of LA reduces procedural time and hospital cost.

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