Cardiac arrest induced by carotid sinus reflex activation during flow-diverter stent deployment
| Autor: | Takashi Izumi, Tomoki Kawaguchi, Mamoru Ishida, Shunsaku Goto, Masato Otawa, Tetsuya Ishida, Masahiro Nishihori, Toshihiko Wakabayashi, Mizuka Ikezawa, Ryosuke Oshima, Asuka Elisabeth Kropp |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
medicine.medical_specialty
business.industry medicine.medical_treatment Vital signs Carotid sinus medicine.disease 03 medical and health sciences Catheter 0302 clinical medicine medicine.anatomical_structure 030220 oncology & carcinogenesis Internal medicine cardiovascular system medicine Cardiology Surgery Local anesthesia Sinus rhythm Neurology (clinical) Embolization Asystole Complication business 030217 neurology & neurosurgery |
| Zdroj: | World neurosurgery. |
| ISSN: | 1878-8769 |
| Popis: | Background A 60-year-old female with multiple carotid aneurysms underwent endovascular treatment with a Pipeline Flex embolization device (PED) under local anesthesia via femoral puncture. Case Description Cardiac arrest occurred when the delivery systems were pushed to promote adequate opening and apposition of the PED against the vessel wall and was recovered to sinus rhythm in approximately 30 seconds by pulling down the microcatheter. The carotid sinus reflex was suspected as the cause of this temporary asystole. Delivery of the PED was accompanied by application of forward pressure on the delivery system. This resulted in buckling of the delivery systems in the neck and likely excessive pressure on the carotid sinus. The procedure was continued and successfully completed with care not to excessively push the system and with the additional use of atropine. Conclusions Although it was a rare complication, the phenomenon and its mechanisms were known in the carotid artery stenting procedure. To the best of our knowledge, this is the first report of cardiac arrest induced by a carotid sinus reflex during PED deployment. It is important for an operator of PED deployment to recognize its possibility. Vital signs should be closely checked during PED deployment, particularly while pushing the catheter. |
| Databáze: | OpenAIRE |
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