Document Detail

Intraarterially administered verapamil as adjunct therapy for cerebral vasospasm: safety and 2-year experience.
MedLine Citation:
PMID:  12223366     Owner:  NLM     Status:  MEDLINE    
BACKGROUND AND PURPOSE: Despite the widespread use of angioplasty, adjunct chemical therapy is often needed to treat patients with cerebral vasospasm. In this study, we examined the safety of intraarterial administration of verapamil to patients with cerebral vasospasm. We herein summarize our 2-year experience with this treatment. METHODS: We retrospectively reviewed the procedure reports, anesthesia records, clinical charts, and brain images of 29 patients who received intraarterially administered verapamil in 34 procedures for the treatment of vasospasm after subarachnoid hemorrhage from July 1998 to June 2000. The average changes in mean arterial pressure and heart rate were used to measure cardiovascular side effects. The neurologic effects were assessed by angiographic findings, the results of neurologic examinations performed before and after the procedure, and findings of CT of the head. RESULTS: The average dose of verapamil per patient was 3 +/- 0 mg or 44 +/- 5 mcg/kg. The average changes in mean arterial pressure at 10 and 20 minutes were -5 +/- 1 mm Hg and -2 +/- 1 mm Hg or -3.8 +/- 1.0% and -1.7 +/- 1.1%, respectively. No significant change of heart rate was observed at 10 minutes. The patients showed no sign of increased intracranial pressure by hemodynamic parameters, neurologic examination, or CT of the head. On 10 occasions, when the effect of verapamil infusion was assessed angiographically, there was 44 +/- 9% increase of vessel diameter in the spastic segment. Neurologic improvement was noted after five of 17 procedures when verapamil was used as the sole treatment. CONCLUSION: Low dose verapamil is safe when administered intraarterially to patients with cerebral vasospasm. Beneficial effects are achieved in some patients, prompting further study of its efficacy.
Lei Feng; Brian-Fred Fitzsimmons; William L Young; Mitchell F Berman; Erwin Lin; Beverly D L Aagaard; Hoang Duong; John Pile-Spellman
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  AJNR. American journal of neuroradiology     Volume:  23     ISSN:  0195-6108     ISO Abbreviation:  AJNR Am J Neuroradiol     Publication Date:  2002 Sep 
Date Detail:
Created Date:  2002-09-11     Completed Date:  2003-01-21     Revised Date:  2008-02-14    
Medline Journal Info:
Nlm Unique ID:  8003708     Medline TA:  AJNR Am J Neuroradiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1284-90     Citation Subset:  IM    
Department of Radiology, College of Physicians & Surgeons, Columbia University, New York, NY 10032, USA.
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MeSH Terms
Calcium Channel Blockers / administration & dosage,  therapeutic use*
Cerebral Angiography
Injections, Intra-Arterial
Middle Aged
Retrospective Studies
Subarachnoid Hemorrhage / complications*,  radiography
Treatment Outcome
Vasospasm, Intracranial / drug therapy*,  etiology,  radiography
Verapamil / administration & dosage,  therapeutic use*
Reg. No./Substance:
0/Calcium Channel Blockers; 52-53-9/Verapamil

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