Safety and efficacy of high-dose adenosine-induced asystole during endovascular AAA repair

Ronald A. Kahn, David M. Moskowitz, Michael L. Marin, Larry H. Hollier, Richard Parsons, Victoria Teodorescu, Maryanne McLaughlin

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64 Scopus citations


Purpose: To assess the safety and efficacy of high-dose adenosine administration to increase the precision of endovascular abdominal aortic aneurysm (AAA) repair using a balloon deployed stent-graft. Methods: From January 1997 to March 1999, 98 AAA patients (79 men; mean age 71 years, range 62-91) were treated with balloon-expandable stent-grafts under an approved protocol. After placing a temporary transvenous ventricular lead or an external transthoracic pacing electrode, adenosine (24 mg initially) was administered in an escalating dose fashion to induce at least 10 seconds of asystole, during which the proximal stent was expanded. Results: Adenosine dosages ranged from 24 to 90 mg (median 24 mg). Nine (9.2%) self-limiting cardiac events were observed: 2 (2.0%) episodes of transient myocardial ischemia, 2 (2.0%) cases of atrial fibrillation requiring cardioversion, 1 (1.0%) transient left bundle branch block lasting < 10 seconds, and 4 (4.1%) prolonged periods of asystole requiring temporary pacemaker activation. There were no cases of bronchospasm or worsening obstructive pulmonary disease, and no patients required inotropic support after adenosine-induced asystole. Conclusions: Cardiac events following adenosine-induced asystole are infrequent, mild, and easily treated. The perioperative use of high-dose adenosine to ensure precise stentgraft placement appears to be a safe method of inducing temporary asystole during endovascular aortic repair.

Original languageEnglish
Pages (from-to)292-296
Number of pages5
JournalJournal of Endovascular Therapy
Issue number4
StatePublished - Aug 2000


  • Abdominal aortic aneurysms
  • Aortomonoiliac stentgraft
  • Cardiac events
  • Deployment technique
  • Endograft
  • Palmaz stent


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