Rapid Ventricular Pacing as a Safe Procedure for Clipping of Complex Ruptured and Unruptured Intracranial Aneurysms

Surgical treatment of intracranial aneurysm requires advanced technologies to achieve optimal results. Recently, rapid ventricular pacing (RVP) has been described to be an elegant technique that facilitates clip reconstruction of complex unruptured intracranial aneurysm (uIA). However, there is also...

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Autores principales:	Josefin Grabert, Stefanie Huber-Petersen, Tim Lampmann, Lars Eichhorn, Hartmut Vatter, Mark Coburn, Markus Velten, Erdem Güresir
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	rapid ventricular pacing intracranial aneurysm subarachnoid hemorrhage controlled hypotension Medicine R
Acceso en línea:	https://doaj.org/article/a8e4cfdc8ab2492b99a35897db2e1345
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spelling	oai:doaj.org-article:a8e4cfdc8ab2492b99a35897db2e13452021-11-25T18:02:29ZRapid Ventricular Pacing as a Safe Procedure for Clipping of Complex Ruptured and Unruptured Intracranial Aneurysms10.3390/jcm102254062077-0383https://doaj.org/article/a8e4cfdc8ab2492b99a35897db2e13452021-11-01T00:00:00Zhttps://www.mdpi.com/2077-0383/10/22/5406https://doaj.org/toc/2077-0383Surgical treatment of intracranial aneurysm requires advanced technologies to achieve optimal results. Recently, rapid ventricular pacing (RVP) has been described to be an elegant technique that facilitates clip reconstruction of complex unruptured intracranial aneurysm (uIA). However, there is also a growing need for intraoperative tools to ensure safe clip reconstruction of complex ruptured intracranial aneurysm (rIA). We conducted a retrospective analysis of 17 patients who underwent RVP during surgical reconstruction of complex aneurysms. Nine patients had uIA while eight patients underwent surgery for rIA suffering from consecutive subarachnoid hemorrhage (SAH). Hemodynamic data, critical events, laboratory results, and anesthesia-related complications were evaluated. No complications were reported concerning anesthesia induction and induction times were similar between patients exhibiting uIA or rIA (<i>p</i> = 0.08). RVP induced a significant decline of median arterial pressure (MAP) in both groups (<i>p</i> < 0.0001). However, median MAP before and after RVP was not different in both groups (uIA group: <i>p</i> = 0.27; rIA group: <i>p</i> = 0.18). Furthermore, high-sensitive Troponin T (hsTnT) levels were not increased after RVP in any group. One patient in the rIA group exhibited ventricular fibrillation and required cardiopulmonary resuscitation, but has presented with cardiac arrest due to SAH. Otherwise, no arrhythmias or complications occurred. In summary, our data suggest RVP to be feasible in surgery for ruptured intracranial aneurysms.Josefin GrabertStefanie Huber-PetersenTim LampmannLars EichhornHartmut VatterMark CoburnMarkus VeltenErdem GüresirMDPI AGarticlerapid ventricular pacingintracranial aneurysmsubarachnoid hemorrhagecontrolled hypotensionMedicineRENJournal of Clinical Medicine, Vol 10, Iss 5406, p 5406 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	rapid ventricular pacing intracranial aneurysm subarachnoid hemorrhage controlled hypotension Medicine R
spellingShingle	rapid ventricular pacing intracranial aneurysm subarachnoid hemorrhage controlled hypotension Medicine R Josefin Grabert Stefanie Huber-Petersen Tim Lampmann Lars Eichhorn Hartmut Vatter Mark Coburn Markus Velten Erdem Güresir Rapid Ventricular Pacing as a Safe Procedure for Clipping of Complex Ruptured and Unruptured Intracranial Aneurysms
description	Surgical treatment of intracranial aneurysm requires advanced technologies to achieve optimal results. Recently, rapid ventricular pacing (RVP) has been described to be an elegant technique that facilitates clip reconstruction of complex unruptured intracranial aneurysm (uIA). However, there is also a growing need for intraoperative tools to ensure safe clip reconstruction of complex ruptured intracranial aneurysm (rIA). We conducted a retrospective analysis of 17 patients who underwent RVP during surgical reconstruction of complex aneurysms. Nine patients had uIA while eight patients underwent surgery for rIA suffering from consecutive subarachnoid hemorrhage (SAH). Hemodynamic data, critical events, laboratory results, and anesthesia-related complications were evaluated. No complications were reported concerning anesthesia induction and induction times were similar between patients exhibiting uIA or rIA (<i>p</i> = 0.08). RVP induced a significant decline of median arterial pressure (MAP) in both groups (<i>p</i> < 0.0001). However, median MAP before and after RVP was not different in both groups (uIA group: <i>p</i> = 0.27; rIA group: <i>p</i> = 0.18). Furthermore, high-sensitive Troponin T (hsTnT) levels were not increased after RVP in any group. One patient in the rIA group exhibited ventricular fibrillation and required cardiopulmonary resuscitation, but has presented with cardiac arrest due to SAH. Otherwise, no arrhythmias or complications occurred. In summary, our data suggest RVP to be feasible in surgery for ruptured intracranial aneurysms.
format	article
author	Josefin Grabert Stefanie Huber-Petersen Tim Lampmann Lars Eichhorn Hartmut Vatter Mark Coburn Markus Velten Erdem Güresir
author_facet	Josefin Grabert Stefanie Huber-Petersen Tim Lampmann Lars Eichhorn Hartmut Vatter Mark Coburn Markus Velten Erdem Güresir
author_sort	Josefin Grabert
title	Rapid Ventricular Pacing as a Safe Procedure for Clipping of Complex Ruptured and Unruptured Intracranial Aneurysms
title_short	Rapid Ventricular Pacing as a Safe Procedure for Clipping of Complex Ruptured and Unruptured Intracranial Aneurysms
title_full	Rapid Ventricular Pacing as a Safe Procedure for Clipping of Complex Ruptured and Unruptured Intracranial Aneurysms
title_fullStr	Rapid Ventricular Pacing as a Safe Procedure for Clipping of Complex Ruptured and Unruptured Intracranial Aneurysms
title_full_unstemmed	Rapid Ventricular Pacing as a Safe Procedure for Clipping of Complex Ruptured and Unruptured Intracranial Aneurysms
title_sort	rapid ventricular pacing as a safe procedure for clipping of complex ruptured and unruptured intracranial aneurysms
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/a8e4cfdc8ab2492b99a35897db2e1345
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Rapid Ventricular Pacing as a Safe Procedure for Clipping of Complex Ruptured and Unruptured Intracranial Aneurysms

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