Endovascular Treatment of Symptomatic Vasospasm after Aneurysmal Subarachnoid Hemorrhage: A Three-year Experience
Journal of Cerebrovascular and Endovascular Neurosurgery
;
: 155-161, 2017.
Article
in English
| WPRIM
| ID: wpr-203989
ABSTRACT
OBJECTIVE:
The cause of severe clinical vasospasm after aneurysmal subarachnoid hemorrhage remains unknown, despite extensive research over the past 30 years. However, the intra-arterial administration of vasodilating agents and balloon angioplasty have been successfully used in severe refractory cerebral vasospasm. MATERIALS ANDMETHODS:
We retrospectively analyzed the data of 233 patients admitted to our institute with aneurysmal subarachnoid hemorrhage (SAH) over the past 3 years.RESULTS:
Of these, 27 (10.6%) developed severe symptomatic vasospasm, requiring endovascular therapy. Vasospasm occurred at an average of 5.3 days after SAH. A total of 46 endovascular procedures were performed in 27 patients. Endovascular therapy was performed once in 18 (66.7%) patients, 2 times in 4 (14.8%) patients, 3 or more times in 5 (18.5%) patients. Intra-arterial vasodilating agents were used in 44 procedures (27 with nimodipine infusion, 17 with nicardipine infusion). Balloon angioplasty was performed in only 2 (7.4%) patients. The Average nimodipine infusion volume was 2.47 mg, and nicardipine was 3.78 mg. Most patients recovered after the initial emergency room visit. Two patients (7.4%) worsened, but there were no deaths.CONCLUSION:
With advances in endovascular techniques, administration of vasodilating agents and balloon angioplasty reduces the morbidity and mortality of vasospasm after aneurysmal SAH.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Subarachnoid Hemorrhage
/
Nicardipine
/
Nimodipine
/
Retrospective Studies
/
Mortality
/
Angioplasty, Balloon
/
Vasospasm, Intracranial
/
Emergency Service, Hospital
/
Endovascular Procedures
/
Aneurysm
Type of study:
Diagnostic study
/
Observational study
/
Prognostic study
Limits:
Humans
Language:
English
Journal:
Journal of Cerebrovascular and Endovascular Neurosurgery
Year:
2017
Type:
Article
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