Transient Cardiac Arrest Induced by Adenosine: A Tool for Contralateral Clipping of Internal Carotid Artery-Ophthalmic Segment Aneurysms

World Neurosurgery
Hugo Andrade-BarazarteJuha Hernesniemi

Abstract

The disadvantages of a contralateral approach (CA) include deep and narrow surgical corridors and inconsistent ability to achieve proximal control of the supraclinoid internal carotid artery (ICA). However, a CA remains as a microsurgical option for selected ICA-ophthalmic (opht) segment aneurysms. To describe transient cardiac arrest induced by adenosine as an alternative tool to obtain proximal vascular control and soften the aneurysm sac in selected patients while performing a CA. From January 1998 to December 2013, we retrospectively identified 30 patients with ICA-opht segment aneurysms treated through a CA. Of those, 8 patients received an intravenous bolus of adenosine to induce transient cardiac arrest for softening of the aneurysm sac. We reviewed preoperative clinical status, characteristics of the contralateral aneurysm, adenosine doses, asystole time, recovery of normal circulation, outcome, and complications. No preoperative cardiac or pulmonary pathologies were found in the study population. All contralateral ICA-opht segment aneurysms were unruptured, small, and saccular in shape. Transient cardiac arrest was induced because it was impossible to apply a temporary clip on the parent contralateral supraclinoid ICA....Continue Reading

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Citations

Oct 28, 2017·Journal of Neurosurgery·Patcharin IntarakhaoJuha Hernesniemi
Aug 1, 2019·British Journal of Neurosurgery·Eric S Nussbaum, Kevin M Kallmes
Mar 7, 2018·Stroke and Vascular Neurology·Virendra R DesaiGavin W Britz
Oct 17, 2019·Neurosurgical Review·Torstein R Meling, Alexandre Lavé
Jul 25, 2017·Neurosurgical Review·Alaa Al-MousaAhmed K Toma
May 18, 2020·Neurology India·Narayanam A Sai KiranAlangar S Hegde

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