Simultaneous Endovascular Treatment of Ruptured Cerebral Aneurysms and Vasospasm
نویسندگان
چکیده
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. After placement of a guiding catheter within the proximal internal carotid artery for coil embolization, an infusion line of nimodipine was wired to one hub, and of a microcatheter was advanced through another hub (to select and deliver detachable coils). Nimodipine was then infused continuously during the coil embolization. RESULTS This technique was applied to 11 ruptured aneurysms accompanied by vasospasm (anterior communicating artery, 6 patients; internal carotid artery, 2 patients; posterior communicating and middle cerebral arteries, 1 patient each). Aneurysmal occlusion by coils and nimodipine-induced angioplasty were simultaneously achieved, resulting in excellent outcomes for all patients, and there were no procedure-related complications. Eight patients required repeated nimodipine infusions. CONCLUSION Our small series of patients suggests that the simultaneous endovascular management of ruptured cerebral aneurysms and vasospasm is a viable approach in patients presenting with subarachnoid hemorrhage and severe vasospasm.
منابع مشابه
Treatment of ruptured cerebral aneurysms - clip and coil, not clip versus coil.
BACKGROUND AND AIMS Recent advances in neurosurgery and interventional neuroradiology have brought us a new aspect in the treatment of cerebral aneurysms. The present single-surgeon series provides a balanced overview of the treatment of ruptured aneurysms in surgical clipping and coil embolization. CLINICAL MATERIALS AND METHODS One hundred consecutive patients with ruptured cerebral aneurys...
متن کاملEffect of Endovascular Services and Hospital Volume on Cerebral Aneurysm Treatment Outcomes
Background and Purpose—Endovascular coil embolization and angioplasty for cerebral vasospasm are offered by some centers for the treatment of unruptured and ruptured cerebral aneurysms. Whether the availability of these therapies improves outcomes at these institutions has not been evaluated. Methods—We assessed institutional factors in the outcomes of patients treated for cerebral aneurysms in...
متن کاملEffect of endovascular services and hospital volume on cerebral aneurysm treatment outcomes.
BACKGROUND AND PURPOSE Endovascular coil embolization and angioplasty for cerebral vasospasm are offered by some centers for the treatment of unruptured and ruptured cerebral aneurysms. Whether the availability of these therapies improves outcomes at these institutions has not been evaluated. METHODS We assessed institutional factors in the outcomes of patients treated for cerebral aneurysms ...
متن کاملSymptomatic Cerebral Vasospasm after Surgical Ligation of Unruptured Aneurysms
Background Cerebral artery vasospasm accounts for the majority of delayed neurological deficits in ruptured aneurysm patients. We report two cases and review the literature* of patients who developed symptomatic vasospasm after treatment for unruptured cerebral artery aneurysms with clip ligation. Preand post-operative imaging and studies revealed absence of subarachnoid or focal hemorrhage. Ca...
متن کاملDoes the method of treatment of acutely ruptured intracranial aneurysms influence the incidence and duration of cerebral vasospasm and clinical outcome?
OBJECTIVES Cerebral vasospasm remains the leading cause of death and permanent disability after subarachnoid haemorrhage. This study determined whether the method of aneurysm treatment plays an important role in determining the incidence of cerebral vasospasm and its clinical consequences. METHODS Admission data, cranial computed tomography (CT), treatment details, transcranial Doppler (TCD) ...
متن کامل