Perioperative cardiac complications and 30-day mortality in patients undergoing intracranial aneurysmal surgery with adenosine-induced flow arrest: a retrospective comparative study.

Journal Article (Journal Article)

BACKGROUND: Adenosine-induced flow arrest is a technique used to assist in the surgical clipping of complex aneurysms. OBJECTIVE: To assess the safety associated with adenosine-assisted intracranial aneurysm surgery. METHODS: Medical records of all patients presenting between January 1, 2009, and December 31, 2012, for intracranial aneurysm surgery were analyzed. Patients were divided into 2 groups based on the intraoperative administration of adenosine: the nonadenosine group (n = 262) and the adenosine group (n = 64). The primary outcome compared between groups included a composite of 30-day mortality and incidences of perioperative cardiac complications (perioperative myocardial infarction or perioperative cardiac arrhythmias). RESULTS: The study groups were statistically similar except for a difference in the size and location of cerebral aneurysms and the incidence of coronary artery disease. The primary composite outcome occurred in 4.6% and 9.4% of patients in the nonadenosine and adenosine groups, respectively (P = .13). After adjustment for differences in the incidence of coronary artery disease between the 2 groups, the odds of the primary outcome were not significantly different between the groups (adjusted odds ratio = 2.12; 95% confidence interval, 0.76-5.93; P = .15). There were also no significant differences in the durations of hospital and intensive care unit stay between the study groups. CONCLUSION: Our results suggest that adenosine-assisted intracranial aneurysm surgery is not associated with an increase in perioperative cardiac complications or mortality in patients with low risk of coronary artery disease and may be considered a safe technique to assist clipping of complex aneurysms.

Full Text

Duke Authors

Cited Authors

  • Khan, SA; McDonagh, DL; Adogwa, O; Gokhale, S; Toche, UN; Verla, T; Zomorodi, AR; Britz, GW

Published Date

  • March 2014

Published In

Volume / Issue

  • 74 / 3

Start / End Page

  • 267 - 271

PubMed ID

  • 24276504

Electronic International Standard Serial Number (EISSN)

  • 1524-4040

Digital Object Identifier (DOI)

  • 10.1227/NEU.0000000000000258


  • eng

Conference Location

  • United States