Adenosine-induced cardiac arrest as an alternative to temporary clipping during intracranial aneurysm surgery

Journal of Neurosurgery
Patcharin IntarakhaoJ Hernesniemi

Abstract

OBJECTIVE The purpose of this study was to analyze the impact of adenosine-induced cardiac arrest (AiCA) on temporary clipping (TC) and the postoperative cerebral infarction rate among patients undergoing intracranial aneurysm surgery. METHODS In this retrospective matched-cohort study, 65 patients who received adenosine for decompression of aneurysms during microsurgical clipping were identified (Group A) and randomly matched with 65 selected patients who underwent clipping but did not receive adenosine during surgery (Group B). The matching criteria included age, Fisher grade, aneurysm size, rupture status, and location of aneurysms. The primary outcomes were TC time and the postoperative infarction rate. The secondary outcome was the incidence of intraoperative aneurysm rupture (IAR). RESULTS In Group A, 40 patients underwent clipping with AiCA alone and 25 patients (38%) received AiCA combined with TC, and in Group B, 60 patients (92%) underwent aneurysm clipping under the protection of TC (OR 0.052; 95% CI 0.018-0.147; p < 0.001). Group A required less TC time (2.04 minutes vs 4.46 minutes; p < 0.001). The incidence of postoperative lacunar infarction was equal in both groups (6.2%). There was an insignificant between-grou...Continue Reading

References

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Sep 24, 2010·World Neurosurgery·Teemu LuostarinenTarja Randell
Oct 9, 2013·Acta neurochirurgica·Ahmed ElsharkawyJuha Hernesniemi
May 2, 2015·Neurosurgical Review·Leonardo Rangel-CastillaRobert F Spetzler

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Methods Mentioned

BETA
dissection

Software Mentioned

SPSS Statistics
AiCA
IMPAX

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