Document Detail


Safety and efficacy of high-dose adenosine-induced asystole during endovascular AAA repair.
MedLine Citation:
PMID:  10958293     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To assess the safety and efficacy of high-dose adenosine administration to increase the precision of endovascular abdominal aortic aneurysm (AAA) repair using a balloon deployed stent-graft. METHODS: From January 1997 to March 1999, 98 AAA patients (79 men; mean age 71 years, range 62-91) were treated with balloon-expandable stent-grafts under an approved protocol. After placing a temporary transvenous ventricular lead or an external transthoracic pacing electrode, adenosine (24 mg initially) was administered in an escalating dose fashion to induce at least 10 seconds of asystole, during which the proximal stent was expanded. RESULTS: Adenosine dosages ranged from 24 to 90 mg (median 24 mg). Nine (9.2%) self-limiting cardiac events were observed: 2 (2.0%) episodes of transient myocardial ischemia, 2 (2.0%) cases of atrial fibrillation requiring cardioversion, 1 (1.0%) transient left bundle branch block lasting <10 seconds, and 4 (4.1%) prolonged periods of asystole requiring temporary pacemaker activation. There were no cases of bronchospasm or worsening obstructive pulmonary disease, and no patients required inotropic support after adenosine-induced asystole. CONCLUSIONS: Cardiac events following adenosine-induced asystole are infrequent, mild, and easily treated. The perioperative use of high-dose adenosine to ensure precise stent-graft placement appears to be a safe method of inducing temporary asystole during endovascular aortic repair.
Authors:
R A Kahn; D M Moskowitz; M L Marin; L H Hollier; R Parsons; V Teodorescu; M McLaughlin
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of endovascular therapy : an official journal of the International Society of Endovascular Specialists     Volume:  7     ISSN:  1526-6028     ISO Abbreviation:  J. Endovasc. Ther.     Publication Date:  2000 Aug 
Date Detail:
Created Date:  2000-12-04     Completed Date:  2000-12-14     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  100896915     Medline TA:  J Endovasc Ther     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  292-6     Citation Subset:  IM    
Affiliation:
Department of Anesthesiology, The Mount Sinai-New York University Medical Center, New York 10029, USA. ron_kahn@smtplink.mssm.edu
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MeSH Terms
Descriptor/Qualifier:
Adenosine / administration & dosage*,  adverse effects
Aged
Aged, 80 and over
Aortic Aneurysm, Abdominal / surgery*
Blood Vessel Prosthesis Implantation*
Female
Heart Arrest, Induced*
Humans
Male
Middle Aged
Stents*
Chemical
Reg. No./Substance:
58-61-7/Adenosine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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