Adenosine-induced flow arrest to facilitate intracranial complex aneurysm clip ligation: Review of the literature

Author:

Wang XiangDong12,Feletti Alberto1,Tanaka Riki1,Yamada Yasuhiro1,Suyama Daisuke1,Kawase Tsukasa1,Kato Yoko1

Affiliation:

1. Department of Neurosurgery, Banbuntane Hotokukai Hospital, Fujita Health University, Nagoya, Japan

2. Department of Neurosurgery, Heji Hospital, Changzhi Medical College, ChangZhi City, Shan Xi Province, China

Abstract

Complex intracranial aneurysms (CIAs) rank high among the most technically demanding neurosurgical pathologies. Microsurgery and clip ligation can be challenging in CIAs as circumferential visualization of the aneurysm, parent vessels, branches, perforators, and other neurovascular structures is important to prevent residual aneurysms or strokes from vessel or perforator occlusion. Decompression of the aneurysm sac is often required for CIAs. We reviewed the literature and PubMed advanced search showed 13 results of adenosine-induced flow arrest to facilitate intracranial complex aneurysm clip ligation which included three independent case reports and ten cases in a case series from 1999 to May 2016. Few case series have described the use of adenosine in intracranial aneurysm surgery. Satisfactory aneurysm decompression was achieved in all cases, and all aneurysms were clipped successfully. We recommend that adenosine cardiac arrest is a relatively novel method for decompression of intracranial aneurysms to facilitate clip application. With appropriate safety precautions, it is a reasonable alternative method when temporary clipping of proximal vessels is not desirable or not possible.

Publisher

Georg Thieme Verlag KG

Reference30 articles.

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