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Intravascular Infusion of Lidocaine: A Novel Way to Relieve Sudden Internal Carotid Artery Occlusion in Embolization of Intracranial Aneurysms.
MedLine Citation:
PMID:  22241594     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: Sudden internal carotid artery (ICA) occlusive vasospasm is a serious complication of intracranial aneurysm embolization. Conventional spasmolysis with papaverine yields a generally poor outcome. We believe that arterial infusion of lidocaine may offer a better outcome. MATERIALS AND METHODS: We retrospectively reviewed the outcome of patients treated with either papaverine or lidocaine infusion for vasospasm during embolization. RESULTS: 14 patients undergoing intracranial aneurysm embolization had a ICA occlusive vasospasm. Among the 8 patients who received conventional treatment with papaverine the vasospasm improved partially in 5. In 3 cases, treatment was ineffective. 6 of the patients died within 3 days. 2 patients developed hemispheric infarction and underwent a decompressive craniectomy and subtotal resection of the infarct; 1 of these 2 patients died after 4 months and the other was severely disabled. In the 6 patients treated with lidocaine, spasmolysis and subsequent aneurysm treatment was succesful in 5. In 1 patient who had preoperative stenosis of the carotid artery proximal to the aneurysm spasmolysis failed. CONCLUSIONS: ICA occlusive spasm is an extremely serious and often lethal complication in embolization of intracranial aneurysms. Conventional treatment with papaverine has a poor outcome, whereas arterial infusion of lidocaine may achieve better results.
Authors:
Qiao Yu Li; Wen Lin Xu; Yan Zhang; Pej Shan Lu; Zhi Cheng Yuan; Li Ping Zhan; Peng Wang; Xia Yu Lu; Bo Cheng
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-1-12
Journal Detail:
Title:  Central European neurosurgery     Volume:  -     ISSN:  1868-4912     ISO Abbreviation:  -     Publication Date:  2012 Jan 
Date Detail:
Created Date:  2012-1-13     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101501500     Medline TA:  Cen Eur Neurosurg     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© Georg Thieme Verlag KG Stuttgart · New York.
Affiliation:
The Affiliated People's Hospital of Jiangsu University, Department of Neurosurgery, Zhenjiang, China.
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