Efficacy of endovascular surgery for ruptured aneurysms with vasospasm of the parent artery.
نویسندگان
چکیده
INTRODUCTION In the presence of vasospasm it is recommended that surgical clipping for a ruptured aneurysm should be delayed until it disappears, but this may be associated with re-rupture of the aneurysm resulting in a poor outcome. The indications for endovascular coil embolization in such cases are discussed. METHODS Since November 2002, endovascular coil embolization has been used in 18 consecutive patients with ruptured aneurysm with vasospasm of the parent artery ranging from 2 to 28 days (mean 9 days) after the initial subarachnoid hemorrhage. After successful obliteration of the aneurysm, a microcatheter preceded by a guidewire was introduced into the peripheral vessels with vasospasm of the A2 or M2 portions in order to release the vasospasm mechanically. RESULTS Endovascular procedures were performed successfully in all but one of the cases (94%), resulting in complete occlusion in 14 of 17 patients and mild dilation of the vasospasm in all 17 patients without technical complications or re-rupture of the aneurysm. In the one case of failure because of a tortuous artery, surgical clipping was performed after disappearance of the vasospasm. Cerebral infarction occurred in four patients, but only one correlated with the distribution of catheterization and the neurological deficits had completely disappeared 3 months after the onset. CONCLUSION Catheterization of parent vessels in cases of vasospasm is safe for coiling and also mechanically releases vasospasm. Vasospasm of M2 and A2 segments can be treated with microcatheterization only.
منابع مشابه
Successful endovascular coiling of a ruptured internal iliac artery aneurysm: a case report
Ruptured internal iliac artery aneurysms (IIAA) are extremely rare, and the repair can be challenging. This case reports described an 83-year-old patient who presented at our Emergency Department with acute abdominal pain based on a ruptured IIAA. He refused open repair and only wanted to be treated as minimally invasive as possible. Therefore endovascular embolization of the IIAA was performed...
متن کاملRuptured vertebral artery dissecting aneurysms treated with endovascular treatment.
Intracranial vertebral artery (VA) dissecting aneurysms often present with severe subarachnoid hemorrhage (SAH) and a subsequent high rate of mortality. We retrospectively studied the treatment efficacy and outcomes of 26 patients with ruptured VA dissecting aneurysms treated with endovascular surgery. Twenty-six patients with ruptured VA dissecting aneurysms were enrolled. Fifteen patients pre...
متن کاملSimultaneous Endovascular Treatment of Ruptured Cerebral Aneurysms and Vasospasm
OBJECTIVE The management of patients with ruptured cerebral aneurysms and severe vasospasm is subject to considerable controversy. We intended to describe herein an endovascular technique for the simultaneous treatment of aneurysms and vasospasm. MATERIALS AND METHODS A series of 11 patients undergoing simultaneous endovascular treatment of ruptured aneurysms and vasospasm were reviewed. Afte...
متن کاملDelayed Bilateral Symptomatic Vasospasm after Resection of a Skull Base Meningioma: Report on a New Case and Literature Review
Background and Importance: Symptomatic vasospasm is a well-known pathology associated with ruptured aneurysms. Nevertheless, this condition is rarely found as a result of skull base tumor removal. Case Presentation: We reported a new case of 40-year-old woman previously treated for a tuberculum and diaphragma sellae meningioma showing symptomatic vasospasm after twelve post-operative days wi...
متن کاملEndovascular treatment of middle cerebral artery aneurysms with electrolytically detachable coils.
BACKGROUND AND PURPOSE Middle cerebral artery (MCA) aneurysms often have an unfavorable aneurysm geometry that might limit endovascular therapy. Our purpose was to analyze the feasibility, safety, and efficacy of coil embolization in a consecutive series of MCA aneurysms chosen for endovascular treatment. PATIENTS AND TECHNIQUES Of 235 MCA aneurysms seen at our institution during the past 5 y...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
عنوان ژورنال:
- Journal of neurointerventional surgery
دوره 4 3 شماره
صفحات -
تاریخ انتشار 2012