title: Multidose Adenosine Used to Facilitate Microsurgical Clipping of a Cerebral Aneurysm Complicated by Intraoperative Rupture: A Case Report.
abstract: In some cases of cerebral aneurysm clipping, direct clip application to the aneurysm neck may be difficult or the aneurysm may rupture unexpectedly. In these cases, a clip may be temporarily applied to the parent artery to reduce aneurysmal wall tension, facilitate permanent clip placement, or control bleeding if the aneurysm ruptures. In certain circumstances, even applying a temporary clip may be challenging. We present a case in which the aneurysm ruptured and IV administration of adenosine was required to facilitate clipping. This case suggests that administering multiple consecutive precalculated doses of adenosine may be a safe method to manage aneurysmal rupture.
authors.affiliation: From the *Northwestern University Feinberg School of Medicine, Chicago, Illinois; and †Mayo Clinic, Phoenix, Arizona.
authors.forename: Ryan
authors.initials: R
authors.lastname: Vealey
authors.forename: Antoun
authors.initials: A
authors.lastname: Koht
authors.forename: Bernard R
authors.initials: BR
authors.lastname: Bendok
mesh_terms: D000241:Adenosine / Q000627:therapeutic use*; D017542:Aneurysm, Ruptured / Q000188:drug therapy* / Q000601:surgery; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000601:surgery*; D007431:Intraoperative Complications / Q000188:drug therapy* / Q000601:surgery; D008866:Microsurgery / Q000379:methods*; D008875:Middle Aged; D020768:Middle Cerebral Artery / Q000601:surgery*; D013345:Subarachnoid Hemorrhage / Q000601:surgery*; D013525:Surgical Instruments; D014665:Vasodilator Agents / Q000627:therapeutic use*
chemical_list: D014665:Vasodilator Agents; D000241:Adenosine