Intra-Arterial Lidocaine Blunts the Trigeminocardiac Reflex during Endovascular Treatment of a Carotid-Cavernous Fistula

Carotid-cavernous fistulas (CCFs) are vascular shunts that allow blood to flow from the carotid artery or its branches into the cavernous sinus. Endovascular embolization is the treatment modality of choice. The trigeminocardiac reflex (TCR) is a vagally mediated reflex that can lead to hemodynamic...

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Published inCase reports in anesthesiology Vol. 2021; pp. 2342347 - 4
Main Authors Coleman, Renee L., Bezinover, Dmitri, Jones, Douglas C., Cockroft, Kevin M., Parekh, Uma R.
Format Journal Article
LanguageEnglish
Published United States Hindawi 05.01.2021
John Wiley & Sons, Inc
Hindawi Limited
Subjects
Anesthesia
Blood pressure
Bupivacaine
Cardiac arrhythmia
Care and treatment
Carotid arteries
Case Report
Case reports
Catheters
Dexmedetomidine
Embolization
Fentanyl
Fistula
Heart rate
Hypotension
Hypoxia
Lidocaine
Medical imaging
Opioids
Sinuses
Surgery
Veins & arteries
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Summary:Carotid-cavernous fistulas (CCFs) are vascular shunts that allow blood to flow from the carotid artery or its branches into the cavernous sinus. Endovascular embolization is the treatment modality of choice. The trigeminocardiac reflex (TCR) is a vagally mediated reflex that can lead to hemodynamic instability. It can be activated during embolization procedures due to the proximity of vagal efferent neurovascular structures within the cavernous sinus. This case report describes the intraoperative management of recurrent, profound bradycardia due to TCR during endovascular CCF embolization.
Bibliography:Academic Editor: Serkan Tulgar
ISSN:2090-6382
2090-6390
DOI:10.1155/2021/2342347