Document Detail

Angioplasty of vasospasm: is it reasonable?
MedLine Citation:
PMID:  7913537     Owner:  NLM     Status:  MEDLINE    
Clinical and radiographic examinations indicate preliminarily indications that transluminal angioplasty may be effective in overall management of the patient with vasospasm. Many questions remain, including: How does it work?; Are the effects persistent?; Is the arterial wall injured by the process? Recent studies in several patients who died after angioplasty allow us to provide some answers. Undilated spastic arteries show proliferation of both cellular and connective tissue elements. There is good evidence that myofibroblasts have reorganized the collagen framework, increasing fibril density and thus thickness. Dilated vessels show thinning of the arterial wall without disruption but with compaction of the new collagen fibrils. Cellular nests are also compressed and stretched. The endothelial layers are undisturbed. The success of dilatation depends on the amount and location of proliferation present. The effect is usually permanent. Because our protocols call for dilatation no greater than 10% above normal diameter, the muscle layers have not been torn or stretched although focal areas of necrosis are sometimes seen. Understanding the constrictive process and its relief through dilatation, allows us to formulate a therapeutic plan. Our experience in treating 89 patients with vasospasm after SAH suggests that, for best results, angioplasty should be performed before the angiopathic features become florid. This helps to preserve flow through the short arteries to the brain stem and deep brain nuclei, which may be involved indirectly in the vasospastic process.
Y N Zubkov; L F Alexander; R R Smith; G M Benashvili; V Semenyutin; D Bernanke
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Neurological research     Volume:  16     ISSN:  0161-6412     ISO Abbreviation:  Neurol. Res.     Publication Date:  1994 Feb 
Date Detail:
Created Date:  1994-08-16     Completed Date:  1994-08-16     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  7905298     Medline TA:  Neurol Res     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  9-11     Citation Subset:  IM    
Polenov Neurosurgical Institute, St. Petersburg, Russia.
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MeSH Terms
Angioplasty, Balloon*
Evaluation Studies as Topic
Intracranial Aneurysm / complications
Ischemic Attack, Transient / etiology,  therapy*
Subarachnoid Hemorrhage / complications

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