Related Experiment Video
Updated: Nov 2, 2025
14:58
Comprehensive Endovascular and Open Surgical Management of Cerebral Arteriovenous Malformations
Published on: October 20, 2017
9.9K
Adenosine-induced Asystole during AVM Embolization : A Case Series
V Hellstern1, P Bhogal2, M Aguilar Pérez1
1Neuroradiological Clinic, Klinikum Stuttgart, Stuttgart, Germany.
Clinical Neuroradiology
|June 14, 2021
Summary
Adenosine induced cardiac standstill is a safe and effective adjunct for brain arteriovenous malformation (AVM) embolization, showing low rates of permanent neurological deficits and mortality in a retrospective study.
Area of Science:
- Neurosurgery
- Interventional Radiology
- Cardiology
Background:
- Adenosine-induced cardiac standstill is an established intraoperative technique for aneurysm and AVM surgery.
- Its utility as an adjunct to endovascular embolization of brain AVMs requires further investigation.
Purpose of the Study:
- To report the outcomes of using adenosine-induced cardiac standstill during endovascular embolization of brain AVMs.
Main Methods:
- Retrospective analysis of a prospectively maintained database of patients undergoing brain AVM embolization with adenosine-induced cardiac standstill since January 2007.
- Data collected included demographics, AVM characteristics (Spetzler Martin grade, rupture status), treatment details, and clinical/radiological outcomes.
Main Results:
- 47 patients (22 female, mean age 42) with various Spetzler Martin grades underwent AVM embolization with adenosine.
- Overall morbidity was 17%, mortality 2.1%, with 10.6% permanent morbidity.
- Angiographic follow-up showed no residual shunt in 81% of patients (26/32).
- 93.5% of patients (43/46) had a modified Rankin Scale score ≤2 at last follow-up.
Conclusions:
- Adenosine-induced cardiac standstill is a viable strategy for embolizing high-flow AVMs or AV shunts.
- This technique is associated with a low risk of mortality and permanent neurological deficits.
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