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66th Annual Meeting of the German Society of Neurosurgery (DGNC)
Friendship Meeting with the Italian Society of Neurosurgery (SINch)

German Society of Neurosurgery (DGNC)

7 - 10 June 2015, Karlsruhe

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Endovascular occlusion of intracranial vessels using nBCA embolization, controlled by adenosine induced asystole

Meeting Abstract

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  • Firas Thaher - Klinik für Neuroradiologie,; Neurochirurgische Klinik
  • Marta Aguilar - Klinik für Neuroradiologie
  • Wiebke Kurre - Klinik für Neuroradiologie
  • Christoph Harmening - Klinik für Anästhesiologie und operative Intensivmedizin, Klinikum Stuttgart
  • Peter Kurucz - Neurochirurgische Klinik
  • Oliver Ganslandt - Neurochirurgische Klinik
  • Hans Henkes - Klinik für Neuroradiologie

Deutsche Gesellschaft für Neurochirurgie. 66. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC). Karlsruhe, 07.-10.06.2015. Düsseldorf: German Medical Science GMS Publishing House; 2015. DocDI.25.06

doi: 10.3205/15dgnc243, urn:nbn:de:0183-15dgnc2435

Published: June 2, 2015

© 2015 Thaher et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

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Objective: To evaluate the efficacy and safety of adenosine induced asystole during the intra-arterial injection of nBCA, aiming at controlled endovascular occlusion of intracranial vessels.

Method: A retrospective analysis of patient files and procedure documentations was performed. Between August 2010 and July 2014, adenosine induced asystole was applied in 29 consecutive procedures, performed in 24 patients (12 female). A total of 21 AVMs, 4 dural AV fistulas, 3 intracranial aneurysms and 1 arterial vessel injury were treated. The procedures were evaluated according to the following criteria:

1.
was asystole achieved?
2.
was the nBCA injection sufficiently controlled?
3.
was a complication of the adenosine injection encountered?
4.
did the nBCA embolization cause adverse effects, related to venous passage or arterial displacement?

Results: Asystole was induced in all 29 attempts. The injection and propagation of nBCA was well controlled in all procedures. All patients returned spontaneously to rhythmic cardiac action, without any circulatory issues. No complication related to venous passage or distal arterial migration of nBCA was observed.

Conclusions: Adenosine induced asystole per se is safe. In high-flow arteriovenous shunts and in rare arterial embolizations (e.g., dissecting aneurysm occlusion), nBCA injection is well controlled if performed under cardiac arrest.