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Triggering of Carotid Sinus Reflex during Deployment of the Flow-diverter Device
The carotid sinus reflex (CSR) is a rare complication of the Pipeline Embolization Device (PED) deployment. No study has assessed the potential risk factors in a case series. The purpose of this study was to examine CSR triggering during PED deployment. Thirty-seven consecutive patients who underwen...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
The Japan Neurosurgical Society
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8531876/ https://www.ncbi.nlm.nih.gov/pubmed/34234082 http://dx.doi.org/10.2176/nmc.oa.2021-0049 |
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author | GOTO, Shunsaku IZUMI, Takashi NISHIHORI, Masahiro TSUKADA, Tetsuya ARAKI, Yoshio UDA, Kenji YOKOYAMA, Kinya SAITO, Ryuta |
author_facet | GOTO, Shunsaku IZUMI, Takashi NISHIHORI, Masahiro TSUKADA, Tetsuya ARAKI, Yoshio UDA, Kenji YOKOYAMA, Kinya SAITO, Ryuta |
author_sort | GOTO, Shunsaku |
collection | PubMed |
description | The carotid sinus reflex (CSR) is a rare complication of the Pipeline Embolization Device (PED) deployment. No study has assessed the potential risk factors in a case series. The purpose of this study was to examine CSR triggering during PED deployment. Thirty-seven consecutive patients who underwent PED deployment were included. All procedures were performed under local anesthesia with mild sedation. We retrospectively analyzed patient characteristics, PED deployment time, and vital signs during the procedure. The vital signs included the pulse rate (PR) and systolic blood pressure (SBP) obtained at three timepoints (pre-deployment, during deployment, post-deployment). We examined the triggering of the CSR during PED deployment by comparing the vital signs at the three timepoints. Moreover, risk factors for CSR were analyzed with univariate analysis. The patients’ average age was 66.3 years. The average size of the aneurysm was 18.0 mm. Six patients (16.2%) showed a decline in the SBP or PR defined as CSR. One patient had a transient cardiac arrest and two had severe transient bradycardia. Deployment into the ophthalmic segment of the internal carotid artery (C2 segment) aneurysm (p = 0.022), prolonged PED deployment time more than 14.5 minutes (p = 0.005), and an acute angle of the anterior genu less than 51.5 degrees (p = 0.005) were risk factors in triggering CSR. CSR may be triggered during PED deployment under local anesthesia with mild sedation. Deployment to the C2 segment aneurysm, prolonged PED deployment time, and an acute angle of the anterior genu were associated with CSR triggering. |
format | Online Article Text |
id | pubmed-8531876 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | The Japan Neurosurgical Society |
record_format | MEDLINE/PubMed |
spelling | pubmed-85318762021-10-27 Triggering of Carotid Sinus Reflex during Deployment of the Flow-diverter Device GOTO, Shunsaku IZUMI, Takashi NISHIHORI, Masahiro TSUKADA, Tetsuya ARAKI, Yoshio UDA, Kenji YOKOYAMA, Kinya SAITO, Ryuta Neurol Med Chir (Tokyo) Original Article The carotid sinus reflex (CSR) is a rare complication of the Pipeline Embolization Device (PED) deployment. No study has assessed the potential risk factors in a case series. The purpose of this study was to examine CSR triggering during PED deployment. Thirty-seven consecutive patients who underwent PED deployment were included. All procedures were performed under local anesthesia with mild sedation. We retrospectively analyzed patient characteristics, PED deployment time, and vital signs during the procedure. The vital signs included the pulse rate (PR) and systolic blood pressure (SBP) obtained at three timepoints (pre-deployment, during deployment, post-deployment). We examined the triggering of the CSR during PED deployment by comparing the vital signs at the three timepoints. Moreover, risk factors for CSR were analyzed with univariate analysis. The patients’ average age was 66.3 years. The average size of the aneurysm was 18.0 mm. Six patients (16.2%) showed a decline in the SBP or PR defined as CSR. One patient had a transient cardiac arrest and two had severe transient bradycardia. Deployment into the ophthalmic segment of the internal carotid artery (C2 segment) aneurysm (p = 0.022), prolonged PED deployment time more than 14.5 minutes (p = 0.005), and an acute angle of the anterior genu less than 51.5 degrees (p = 0.005) were risk factors in triggering CSR. CSR may be triggered during PED deployment under local anesthesia with mild sedation. Deployment to the C2 segment aneurysm, prolonged PED deployment time, and an acute angle of the anterior genu were associated with CSR triggering. The Japan Neurosurgical Society 2021-10 2021-07-07 /pmc/articles/PMC8531876/ /pubmed/34234082 http://dx.doi.org/10.2176/nmc.oa.2021-0049 Text en © 2021 The Japan Neurosurgical Society https://creativecommons.org/licenses/by-nc-nd/4.0/This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/) |
spellingShingle | Original Article GOTO, Shunsaku IZUMI, Takashi NISHIHORI, Masahiro TSUKADA, Tetsuya ARAKI, Yoshio UDA, Kenji YOKOYAMA, Kinya SAITO, Ryuta Triggering of Carotid Sinus Reflex during Deployment of the Flow-diverter Device |
title | Triggering of Carotid Sinus Reflex during Deployment of the Flow-diverter Device |
title_full | Triggering of Carotid Sinus Reflex during Deployment of the Flow-diverter Device |
title_fullStr | Triggering of Carotid Sinus Reflex during Deployment of the Flow-diverter Device |
title_full_unstemmed | Triggering of Carotid Sinus Reflex during Deployment of the Flow-diverter Device |
title_short | Triggering of Carotid Sinus Reflex during Deployment of the Flow-diverter Device |
title_sort | triggering of carotid sinus reflex during deployment of the flow-diverter device |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8531876/ https://www.ncbi.nlm.nih.gov/pubmed/34234082 http://dx.doi.org/10.2176/nmc.oa.2021-0049 |
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