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Introduction Brain aneurysm treatment with the Woven Endo Bridge (WEB ® ) is widely accepted. For long term follow up a non-invasive imaging would be preferable to avoid potential risks from repetitive catheter angiography. Aim of the Study To evaluate which non-invasive imaging modality correlates best with DSA. Methods Four different realistic aneurysm models were designed and 3D printed and a WEB Device was implanted following the official sizing recommendations. Subsequently the devices were partially filled with silicone though a small borehole, intentionally leaving out a proportion of the devices volume. DSA images were made as reference, followed by MRI using T1-, T2-and TOF-sequences, as well as CT and Spectral CT scans. All Images were blinded and reviewed by two experienced readers using the WEB Occlusion Scale (WOS). Results In our model CT and Spectral CT Scans were all scored as WOS 0, resulting in 0% conformity with DSA. The readers agreed in 100% of the cases. Comparing MRI sequences with DSA consistent results were found in 9.4% of the cases. The readers scored concurring WOS in 68.8%. Conclusions From our analysis the detection of small residual inflows into aneurysms treated with WEB Devices, using noninvasive MRI or CT techniques is very unreliable and can not replace DSA for follow up. This is probably not true for recurrences outside the devices. Disclosure FW consults and proctors for Microvention. GK, MP and JM have no conflicts of interest.

Background: Laryngeal mask airway (LMA) does not provide definitive airway protection from pulmonary aspiration of potential regurgitated gastric contents. LMA supreme, a recent supraglottic (extraglottic) airway device, shows promising results. Thus, aim of study to evaluate the role of supreme laryngeal mask airway (SLMA) in airway management of patients operated with laparoscopic procedures under general Anaesthesia. Methods: The prospective observational study comprised of 274 patients of ASA grade 1 and 2 scheduled for short elective laparoscopic procedures (<1hr.30min) who provided consent. Patients were anaesthetised according to standard protocol, appropriate size of SLMA was chosen and inserted; and complications were noted. Post SLMA removal, recovery and trauma of throat were noted. Postoperative complications such as nausea, vomiting, and throat pain were noted. Binary logistic regression model and Chi-square test of association was performed to analyse data (P<0.05). Results: Most participants were female (n=260) with mean age of 31.42±7.24 years. Mean duration of surgery and recovery time was 37.3±5.84 min and 5.85±1.93 min respectively. SLMA size 3 was commonly used (n=245) and majority of insertions were successful in the first attempt (n=244). Post insertion, SLMA had adequate length (n=208) Throat pain (n=37) and vomiting (n=38) were common post-operative complications observed in the patients. A significant association was observed between operative procedure and complication (P=0.0004) and number of attempts (P=0.0004) with trauma being significant (P=0.0039). Trauma was associated with gender (P=0.08) and body weight (P=0.006). Conclusion: SLMA can be used as a standalone supraglottic (extraglottic) airway device for airway management in laparoscopic surgeries.

Background: Use of deep sedation for ERCP is increased due to safer anaesthesia drugs and equipments. Still there are high chances of desaturation,obstructed airway ,respiratory depression requiring skilled airway support with high chances of morbidity and mortality. So we designed a multivariate study for airway management in ERCPwith I –gel under deep sedation. Aim: Gastroenterologist's procedural comfort with respiratory instability leading to desaturation requiring intervention. Objectives: Success in terms of depth of sedation, hemodynamics and recovery time. Method:100 adults of either gender, age of 20 to 60 years, ASAgrade I, II or III, MPC I or II, weight 40-80 kg for elective ERCPlasting up to 90 min were included. Premedication with Inj Glycopyrollate 0.004mg/kg ,Inj Fentanyl 1µg/kg .Inj Propofol 1mg per kg over 3 to 5 min was given and maintenance with infusion 100 µg/kg/min was started after insertion of I gel in prone position. Parameters such as number of patients having desaturation, leading to intubation gastroenterologist's procedural comfort with regard to scope insertion & manipulation and common bile duct (CBD) cannulation were recorded. Also depth of sedation,hemodynamic stability and recovery time were recorded. SPSS 20.0 was used for statistical analysis.Only frequency and percentage were calculated. Results- 1% patient had desaturation who required intubation and GA . Gastroenterologist's comfort for scope insertion was extremely easy in 62%, scope manipulation was extremely easy in 84% patients and for CBD cannulation it was extremely easy in 84% patients. Scope insertion was challenging in 3% patients who needed general anaesthesia with intubation. Depth of sedation was adequate in 94% patients and in 6% patients inadequate. Recovery time was 10-15 min in 65%patients. Conclusion : Use of I –Gel for ERCP under deep sedation signicantly decreases incidences of desaturation and emergency intubation with satisfactory gastroenterologist's comfort