Anesthetic management in a patient of autosomal dominant polycystic kidney disease with end stage renal disease undergoing endovascular coiling for multiple intracranial aneurysms

A 41-year-old male patient, a known case of autosomal dominant polycystic kidney disease (ADPCKD), presented to our institute with right middle cerebral artery aneurysm for which balloon-assisted endovascular coiling was planned. The major comorbidities were hypertension and end-stage renal disease (ESRD) on hemodialysis, twice weekly. Endovascular coiling was performed under general anesthesia, and special precautions were taken with regard to monitoring, fluid management, use of heparin, and contrast agent. The intraoperative and postoperative course was uneventful, and the patient was discharged after 7 days. In this report, various perioperative challenges of patients with chronic renal failure during coiling are discussed along with the measures to prevent the occurrence of contrast-induced nephropathy.

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Anesthetic Considerations for a Patient with Autosomal Dominant Polycystic Kidney Disease, Having a Ruptured Intracranial Aneurysm for Endovascular Coiling: A Case Report

Mahajan

Narayanan

Bhatia

et al. 2022

Asian J Neurosurg

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Autosomal dominant polycystic kidney disease (ADPKD) is a genetic disorder affecting 1 in 1,000 people worldwide. Intracranial aneurysms are an important extrarenal complication with a prevalence of 9 to 12%. The definitive management of an aneurysm includes surgical clipping or endovascular coiling. There is a paucity of literature regarding the anesthetic management of such patients. The pre-existing renal condition is an additional challenge in the management of these patients as the complications associated with chronic kidney disease are superimposed on those due to subarachnoid hemorrhage. Here, we describe anesthetic management of a patient with ADPKD who had a ruptured anterior communicating artery aneurysm, for which endovascular coiling was done.

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Anesthetic management in a patient of autosomal dominant polycystic kidney disease with end stage renal disease undergoing endovascular coiling for multiple intracranial aneurysms

Cited by 4 publications

References 15 publications

Genetic Disorders

Genetic Disorders

Endovascular Coiling in a Patient with Chronic Kidney Disease—A Challenge for Anesthesiologist

Anesthetic Considerations for a Patient with Autosomal Dominant Polycystic Kidney Disease, Having a Ruptured Intracranial Aneurysm for Endovascular Coiling: A Case Report

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