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Cardiovascular diseases are one of the leading causes of morbidity and mortality in Germany. In these patients, the high-risk profile necessitates an interdisciplinary and multimodal approach to treatment. Endovascular interventions and vascular surgery have become established as an important element of this strategy in the past; however, the different anatomical localizations of pathological vascular alterations make it necessary to use a wide spectrum of procedural options and methods; therefore, the requirements for management of anesthesia are variable and necessitate a differentiated approach. Endovascular procedures can be carried out with the patient under general or regional anesthesia (RA); however, in the currently available literature there is no evidence for an advantage of RA over general anesthesia regarding morbidity and mortality, although a reduction in pulmonary complications could be found for some endovascular interventions. Epidural and spinal RA procedures should be carefully considered with respect to the risk-benefit ratio and consideration of the recent guidelines on anesthesia against the background of the current study situation and the regular use of therapy with anticoagulants. The following article elucidates the specific characteristics of anesthesia management as exemplified by some selected endovascular interventions.

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Acetylcholine is a highly important non-electroactive neurotransmitter in the mammalian central nervous system. Its function is linked to memory and sleep, and it regulates, in part, mood and action via its connection to dopamine. A fast, sensitive method to detect the release of acetylcholine at the surface of a single cell is needed to gather data about the kinetics of exocytosis events in these systems.To this end, carbon fiber electrodes have been modified with electrodeposited gold nanoparticles to increase the effective electrode surface area and provide a high curvature surface for enzyme attachment. Acetylcholinesterase and choline oxidase were then deposited onto the gold surfaces to catalyze acetylcholine to hydrogen peroxide for electrochemical detection. The functionalized electrodes have been characterized to determine the K M and V max of the enzymes as well as the total enzyme coverage and gold nanoparticle surface area in order to optimize retained enzyme activity. This optimized design has proven capable of detecting release events from an artificial exocytotic system on a sub-second time scale.