CC BY-NC-ND 4.0 · J Neuroanaesth Crit Care 2019; 06(01): 013-017
DOI: 10.1055/s-0038-1676555
Review Article
Indian Society of Neuroanaesthesiology and Critical Care

Adenosine-Assisted Management of Intracranial Aneurysm

Bhoomika Thakore
1   Neuroanaesthesia Program, Department of Anaesthesiology, P. D. Hinduja Hospital, Mumbai, Maharashtra, India
,
Shwetal Goraksha
1   Neuroanaesthesia Program, Department of Anaesthesiology, P. D. Hinduja Hospital, Mumbai, Maharashtra, India
,
Joseph N. Monteiro
1   Neuroanaesthesia Program, Department of Anaesthesiology, P. D. Hinduja Hospital, Mumbai, Maharashtra, India
› Author Affiliations
Further Information

Publication History

Received: 20 August 2018

Accepted after revision: 01 September 2018

Publication Date:
08 February 2019 (online)

Abstract

Cerebral aneurysms can be complex and variable in size, position, and morphology, resulting in difficult surgical exposure and secure clip placement. They have a high mortality rate when ruptured, and though endovascular techniques have emerged to tackle this, surgical clip ligation remains the preferred modality for some aneurysms. Various techniques that help the surgeon dissect the aneurysmal dome and apply the clip are temporary clip ligation of proximal vessels, deep hypothermic circulatory arrest, and balloon suction decompression. All of them require significant logistics and result in increased morbidity and mortality. Adenosine is a suitable alternative for inducing a temporary flow arrest, causing a short period of controlled hypotension. Its rapid onset and offset property along with low incidence of adverse events makes it an ideal agent in this regard. We present here a review on its use, contraindications, safety profile, and future applications.

 
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