Controlled hypotension under rapid ventricular pacing technique in patients with cerebral arteriovenous malformation: a case report

Korean J Anesthesiol. 2024 Oct 28. doi: 10.4097/kja.24508. Online ahead of print.

Abstract

Background: The transvenous approach to the treatment of cerebral arteriovenous malformation (AVM) is difficult and requires strict blood pressure and blood flow control; however, the cure rate is very high. Appropriate blood pressure control techniques can greatly benefit these patients.

Case: A 55-year-old male patient was found to have an aneurysm complicated with a cerebral AVM (length: 2.0 cm, width: 1.6 cm, height: 1.2 cm). Aneurysm embolization was considered for the first-stage surgery and transvenous arteriovenous malformation embolization for the second-stage surgery. Rapid ventricular pacing (RVP) provided a stable blood flow environment for the surgery, which was completed successfully.

Conclusion: RVP can thus provide an ideal condition for the embolization of cerebral AVM through the transvenous approach and can be a viable surgical option.

Keywords: Anesthesia management; Arteriovenous malformation; Controlled hypotension; Interventional operation; Neuroprotection; Organ protection; Rapid ventricular pacing.

Publication types

  • Case Reports