Ahead of Print: Complications Following Adenosine-Assisted Intracranial- Aneurysmal Surgery

Background: Adenosine-induced flow arrest is a technique that is 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 1st, 2009 and December 31st, 2012 for intracranial aneurysm surgery were analyzed. Patients were divided in two groups based on the intraoperative administration of Adenosine: Non-Adenosine group (n=262) and 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 (CAD). The primary composite outcome occurred in 4.6% and 9.4% of patients in the Non-Adenosine and Adenosine groups, respectively (p=0.13). After adjustment for differences in the incidence of CAD between the two groups, the odds of the primary outcome were not significantly different between the groups (Adjusted Odds ratio= 2.12 (0.76 to 5.93), p=0.15). 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 CAD and may be considered a safe technique to assist clipping of complex aneurysms.

From: Perioperative Cardiac Complications and 30 Day Mortality in Patients Undergoing Intracranial Aneurysmal Surgery With Adenosine Induced Flow Arrest: A Retrospective Comparative Study by Khan et al.

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