title: [Three cases of ATP-induced bronchospasm during thoracic endovascular aortic repair].
abstract: We report three cases (73-year-old, 69-year-old and 76-year-old men) of bronchospasm induced by adenosine triphosphate (ATP) during thoracic endovascular aortic repair (TEVAR). Severe broncospasm occurred soon after administration of ATP to obtain transient asystole during TEVAR. All three cases were complicated with asthma or chronic obstructive pulmonary disease (COPD) before TEVAR, and airway hyper-reactivity was suspected. One case (73-year-old) required postoperative intensive care to treat bronchospasm, and the other two cases recovered during the operation. The possible mechanism of adenosine-induced bronchoconstriction is selective interaction with active mast cells with subsequent release of preformed and newly formed mediators. Careful attention should be paid when ATP is injected during TEVAR in patients with asthma or COPD.
authors.affiliation: Department of Anesthesiology, Sapporo Medical University School of Medicine, Sapporo 060-8543.
authors.forename: Yukimasa
authors.initials: Y
authors.lastname: Takada
authors.forename: Toshiya
authors.initials: T
authors.lastname: Kawagishi
authors.forename: Natsumi
authors.initials: N
authors.lastname: Kii
authors.forename: Misako
authors.initials: M
authors.lastname: Higuchi
authors.forename: Masanori
authors.initials: M
authors.lastname: Yamauchi
authors.forename: Michiaki
authors.initials: M
authors.lastname: Yamakage
mesh_terms: D000255:Adenosine Triphosphate / Q000008:administration & dosage / Q000009:adverse effects*; D000368:Aged; D017545:Aortic Aneurysm, Thoracic / Q000628:therapy*; D001249:Asthma / Q000150:complications; D001986:Bronchial Spasm / Q000139:chemically induced*; D006801:Humans; D007275:Injections, Intravenous; D008297:Male; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications; D015607:Stents
chemical_list: D000255:Adenosine Triphosphate