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Anesthetic Considerations for a Patient with Autosomal Dominant Polycystic Kidney Disease, Having a Ruptured

Shalvi Mahajan1, Vidhya Narayanan2, Vikas Bhatia3

  • 1Division of Neuroanaesthesia, Department of Anaesthesia, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.

Asian Journal of Neurosurgery
|September 19, 2022
PubMed

Insights

Autosomal dominant polycystic kidney disease (ADPKD) patients with intracranial aneurysms require careful anesthetic management. This case report details successful anesthetic strategies for a ruptured anterior communicating artery aneurysm treated with endovascular coiling.

Area of Science:

  • Nephrology
  • Neurology
  • Anesthesiology

Background:

  • Autosomal dominant polycystic kidney disease (ADPKD) affects 1 in 1,000 individuals globally.
  • Intracranial aneurysms are a significant extrarenal complication of ADPKD, occurring in 9-12% of patients.
  • Managing these aneurysms involves surgical clipping or endovascular coiling.

Observation:

  • Anesthetic management for ADPKD patients with intracranial aneurysms is not well-documented.
  • Chronic kidney disease in ADPKD complicates anesthetic care, especially with subarachnoid hemorrhage.
  • This report focuses on the anesthetic approach for a patient with ADPKD and a ruptured anterior communicating artery aneurysm.

Findings:

  • The patient with ADPKD and a ruptured anterior communicating artery aneurysm underwent successful endovascular coiling.
  • Specific anesthetic considerations were applied to manage the superimposed risks of ADPKD and subarachnoid hemorrhage.
  • The anesthetic plan facilitated the safe completion of the endovascular coiling procedure.

Implications:

  • Highlights the need for specialized anesthetic protocols for ADPKD patients undergoing aneurysm treatment.
  • Contributes to the limited literature on anesthetic management in this complex patient population.
  • Informs clinical practice for managing patients with concurrent ADPKD and intracranial aneurysms.

Keywords:
autosomal dominant polycystic kidney disease (ADPKD)cerebrovascular aneurysmendovascular coiling

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