The effect of adenosine in inducing cardiac arrest for endovascular treatment of paediatric high-flow brain and spinal vascular malformation

Ghorbani, M. and Asaadi, S. and Nouri, M. and Asl, M.K. and Lafta, G.A. and Bahrami, R. and Mortazavi, A. (2020) The effect of adenosine in inducing cardiac arrest for endovascular treatment of paediatric high-flow brain and spinal vascular malformation. Neuroradiology Journal, 33 (4). pp. 328-333.

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Introduction: Endovascular treatment of high-flow vascular lesions with onyx may be very dangerous due to premature occlusion of the vein resulting from high flow-induced migration of this embolic substance without occlusion of the feeding vessels and the nidus. It is also dangerous because of the risk of occlusion of the normal vessels around the lesion. Inducing temporary cardiac arrest using adenosine may be helpful in limiting and minimizing these risks. However anaesthetic management of this procedure in children suffering from high-flow vascular lesions is difficult and challenging. Methods: We report three paediatric patients with high-flow cerebrospinal vascular lesions that underwent endovascular treatment under general anaesthesia and temporary cardiac arrest with adenosine. Adenosine was administered in escalating doses to induce a few seconds of cardiac standstill and the onyx injection was synchronized with the onset of adenosine-induced cardiac standstill, the fistula being occluded by onyx. Results: There were no complications in peri-procedural treatment in all three cases. Post-embolization angiography revealed complete obliteration of the lesion, and the patients� neurological status progressively improved at follow-up. Conclusion: Adenosine-induced temporary cardiac standstill was successfully used to facilitate safe and controlled endovascular onyx embolization of high-flow central nervous system vascular lesions. © The Author(s) 2020.

Item Type: Article
Additional Information: cited By 0
Uncontrolled Keywords: adenosine; onyx copolymer, adolescent; anterior cerebral artery; arterial embolization; Article; brain blood flow; case report; catheterization; cerebrospinal fluid circulation disorder; child; clinical article; congenital blood vessel malformation; conventional angiography; digital subtraction angiography; drug dose escalation; endovascular surgery; female; follow up; general anesthesia; heart arrest; human; male; muscle atrophy; muscle strength; muscle weakness; nuclear magnetic resonance imaging; posterior cerebral artery; preschool child; right subclavian artery; spinal cord blood flow; thenar; vertebral artery
Subjects: WG Cardiovascular System
WS Pediatrics
QV Pharmacology
Depositing User: eprints admin
Date Deposited: 23 Sep 2020 04:49
Last Modified: 23 Sep 2020 04:49

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