{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T10:04:22Z","timestamp":1787738662445,"version":"build-2784847793"},"reference-count":16,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,6,14]],"date-time":"2021-06-14T00:00:00Z","timestamp":1623628800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,6,14]],"date-time":"2021-06-14T00:00:00Z","timestamp":1623628800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Clin Neuroradiol"],"published-print":{"date-parts":[[2022,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Adenosine induced cardiac standstill has been used intraoperatively for both aneurysm and arteriovenous malformation (AVM) surgery and embolization. We sought to report the results of adenosine induced cardiac standstill as an adjunct to endovascular embolization of brain AVMs.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Material and Methods<\/jats:title>\n                <jats:p>We retrospectively identified patients in our prospectively maintained database to identify all patients since January 2007 in whom adenosine was used to induce cardiac standstill during the embolization of a\u00a0brain AVM. We recorded demographic data, clinical presentation, Spetzler Martin grade, rupture status, therapeutic intervention and number of embolization sessions, angiographic and clinical results, clinical and radiological outcomes and follow-up information.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>We identified 47\u00a0patients (22\u00a0female, 47%) with average age 42\u202f\u00b1\u200917 years (range 6\u201377 years) who had undergone AVM embolization procedures using adjunctive circulatory standstill with adenosine. In total there were 4\u00a0Spetzler Martin grade\u00a01 (9%), 9\u00a0grade\u00a02 (18%), 15\u00a0grade\u00a03 (32%), 8\u00a0grade\u00a04 (18%), and 11\u00a0grade\u00a05 (23%) lesions. Of the AVMs six were ruptured or had previously ruptured. The average number of embolization procedures per patient was 5.7\u202f\u00b1\u20097.6 (range 1\u201337) with an average of 2.6\u202f\u00b1\u20092.2 (range 1\u201314) embolization procedures using adenosine. Overall morbidity was 17% (<jats:italic>n<\/jats:italic>\u202f=\u20098\/47) and mortality 2.1% (<jats:italic>n<\/jats:italic>\u202f=\u20091\/47), with permanent morbidity seen in 10.6% (<jats:italic>n<\/jats:italic>\u202f=\u20095\/47) postembolization. Angiographic follow-up was available for\u00a032 patients with no residual shunt seen in 26 (81%) and residual shunts seen in 6\u00a0patients (19%). The angiographic follow-up is still pending in 14\u00a0patients. At last follow-up 93.5% of patients were mRS \u22642 (<jats:italic>n<\/jats:italic>\u202f=\u200943\/46).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>Adenosine induced cardiac standstill represents a\u00a0viable treatment strategy in high flow AVMs or AV shunts that carries a\u00a0low risk of mortality and permanent neurological deficits.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00062-021-01035-z","type":"journal-article","created":{"date-parts":[[2021,6,14]],"date-time":"2021-06-14T13:02:36Z","timestamp":1623675756000},"page":"39-48","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Adenosine-induced Asystole during AVM Embolization"],"prefix":"10.1007","volume":"32","author":[{"given":"V.","family":"Hellstern","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5514-5237","authenticated-orcid":false,"given":"P.","family":"Bhogal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Aguilar P\u00e9rez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Alfter","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Kemmling","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E.","family":"Henkes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"O.","family":"Ganslandt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H.","family":"Henkes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,6,14]]},"reference":[{"key":"1035_CR1","doi-asserted-by":"publisher","first-page":"881","DOI":"10.1097\/00006123-199904000-00117","volume":"44","author":"J Pile-Spellman","year":"1999","unstructured":"Pile-Spellman\u00a0J, Young\u00a0WL, Joshi\u00a0S, Duong\u00a0H, Vang\u00a0MC, Hartmann\u00a0A, Kahn\u00a0RA, Rubin\u00a0DA, Prestigiacomo\u00a0CJ, Ostapkovich\u00a0ND. Adenosine-induced cardiac pause for endovascular embolization of cerebral arteriovenous malformations: technical case report. Neurosurgery. 1999;44:881\u20136; discussion 886\u20137.","journal-title":"Neurosurgery"},{"key":"1035_CR2","doi-asserted-by":"publisher","first-page":"1406","DOI":"10.1213\/ANE.0b013e3181d65bf5","volume":"110","author":"JF Bebawy","year":"2010","unstructured":"Bebawy\u00a0JF, Gupta\u00a0DK, Bendok\u00a0BR, Hemmer\u00a0LB, Zeeni\u00a0C, Avram\u00a0MJ, Batjer\u00a0HH, Koht\u00a0A. Adenosine-induced flow arrest to facilitate intracranial aneurysm clip ligation: dose-response data and safety profile. Anesth Analg. 2010;110:1406\u201311.","journal-title":"Anesth Analg"},{"key":"1035_CR3","doi-asserted-by":"publisher","first-page":"1205","DOI":"10.1213\/ANE.0b013e3182a6d31b","volume":"117","author":"JF Bebawy","year":"2013","unstructured":"Bebawy\u00a0JF, Zeeni\u00a0C, Sharma\u00a0S, Kim\u00a0ES, DeWood\u00a0MS, Hemmer\u00a0LB, Ramaiah\u00a0VK, Bendok\u00a0BR, Koht\u00a0A, Gupta\u00a0DK. Adenosine-induced flow arrest to facilitate intracranial aneurysm clip ligation does not worsen neurologic outcome. Anesth Analg. 2013;117:1205\u201310.","journal-title":"Anesth Analg"},{"key":"1035_CR4","doi-asserted-by":"publisher","first-page":"815","DOI":"10.1227\/NEU.0b013e318226632c","volume":"69","author":"BR Bendok","year":"2011","unstructured":"Bendok\u00a0BR, Gupta\u00a0DK, Rahme\u00a0RJ, Eddleman\u00a0CS, Adel\u00a0JG, Sherma\u00a0AK, Surdell\u00a0DL, Bebawy\u00a0JF, Koht\u00a0A, Batjer\u00a0HH. Adenosine for temporary flow arrest during intracranial aneurysm surgery: a single-center retrospective review. Neurosurgery. 2011;69:815\u201320; discussion 820\u20131.","journal-title":"Neurosurgery"},{"key":"1035_CR5","first-page":"87","volume":"58","author":"CA Benech","year":"2014","unstructured":"Benech\u00a0CA, Perez\u00a0R, Faccani\u00a0G, Trompeo\u00a0AC, Cavallo\u00a0S, Beninati\u00a0S, Berardino\u00a0M. Adenosine-induced cardiac arrest in complex cerebral aneurysms surgery: an Italian single-center experience. J Neurosurg Sci. 2014;58:87\u201394.","journal-title":"J Neurosurg Sci"},{"key":"1035_CR6","doi-asserted-by":"publisher","first-page":"35","DOI":"10.1097\/ANA.0b013e3181ef2b11","volume":"23","author":"NR Guinn","year":"2011","unstructured":"Guinn\u00a0NR, McDonagh\u00a0DL, Borel\u00a0CO, Wright\u00a0DR, Zomorodi\u00a0AR, Powers\u00a0CJ, Warner\u00a0DS, Lam\u00a0AM, Britz\u00a0GW. Adenosine-induced transient asystole for intracranial aneurysm surgery: a retrospective review. J Neurosurg Anesthesiol. 2011;23:35\u201340.","journal-title":"J Neurosurg Anesthesiol"},{"key":"1035_CR7","doi-asserted-by":"publisher","first-page":"595","DOI":"10.1007\/s10143-015-0637-z","volume":"38","author":"L Rangel-Castilla","year":"2015","unstructured":"Rangel-Castilla\u00a0L, Russin\u00a0JJ, Britz\u00a0GW, Spetzler\u00a0RF. Update on transient cardiac standstill in cerebrovascular surgery. Neurosurg Rev. 2015;38:595\u2013602.","journal-title":"Neurosurg Rev"},{"key":"1035_CR8","doi-asserted-by":"publisher","first-page":"517","DOI":"10.1007\/s00701-007-1128-y","volume":"149","author":"PA Heppner","year":"2007","unstructured":"Heppner\u00a0PA, Ellegala\u00a0DB, Robertson\u00a0N, Nemergut\u00a0E, Jaganathan\u00a0J, Mee\u00a0E. Basilar tip aneurysm - adenosine induced asystole for the treatment of a basilar tip aneurysm following failure of temporary clipping. Acta Neurochir (Wien). 2007;149:517\u201320; discussion 520\u20131.","journal-title":"Acta Neurochir (Wien)"},{"key":"1035_CR9","doi-asserted-by":"publisher","first-page":"109","DOI":"10.1213\/XAA.0000000000000438","volume":"8","author":"R Vealey","year":"2017","unstructured":"Vealey\u00a0R, Koht\u00a0A, Bendok\u00a0BR. Multidose Adenosine Used to Facilitate Microsurgical Clipping of a Cerebral Aneurysm Complicated by Intraoperative Rupture: A\u00a0Case Report. A A Case Rep. 2017;8:109\u201312.","journal-title":"A A Case Rep"},{"key":"1035_CR10","doi-asserted-by":"publisher","first-page":"E10","DOI":"10.3171\/2014.2.FOCUS13554","volume":"36","author":"JM Wright","year":"2014","unstructured":"Wright\u00a0JM, Huang\u00a0CL, Sharma\u00a0R, Manjila\u00a0S, Xu\u00a0F, Dabb\u00a0B, Bambakidis\u00a0NC. Cardiac standstill and circulatory flow arrest in surgical treatment of intracranial aneurysms: a historical review. 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Impact of Rapid Ventricular Pacing on Outcome After Transcatheter Aortic Valve Replacement. J Am Heart Assoc. 2018;7:e009038.","journal-title":"J Am Heart Assoc"}],"container-title":["Clinical Neuroradiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00062-021-01035-z.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00062-021-01035-z\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00062-021-01035-z.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,3,3]],"date-time":"2022-03-03T10:04:13Z","timestamp":1646301853000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00062-021-01035-z"}},"subtitle":["A\u00a0Case Series"],"short-title":[],"issued":{"date-parts":[[2021,6,14]]},"references-count":16,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2022,3]]}},"alternative-id":["1035"],"URL":"https:\/\/doi.org\/10.1007\/s00062-021-01035-z","relation":{},"ISSN":["1869-1439","1869-1447"],"issn-type":[{"value":"1869-1439","type":"print"},{"value":"1869-1447","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,6,14]]},"assertion":[{"value":"17 November 2020","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"28 April 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"14 June 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"P.\u00a0Bhogal: consultant for phenox, MIVI neurosciences, Balt, serves on advisory board for Cerenovus. M.\u00a0Aguilar P\u00e9rez: proctor and consultant for phenox. H.\u00a0Henkes: co-founder of phenox. V.\u00a0Hellstern, M.\u00a0Alfter, A.\u00a0Kemmling, E.\u00a0Henkes and O.\u00a0Ganslandt declare that they have no competing interests.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"Ethical approval for this study was granted by the ethics commission of Baden-W\u00fcrttemberg (F-2018-080). Informed consent was obtained from all individual patients in those who were able to provide consent or from next of kin in those patients that could give consent themselves.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical standards"}}]}}