Document Detail

Superselective intra-arterial infusion of papaverine for the treatment of cerebral vasospasm after subarachnoid hemorrhage.
MedLine Citation:
PMID:  1432124     Owner:  NLM     Status:  MEDLINE    
This report describes the successful treatment of cerebral vasospasm after subarachnoid hemorrhage with superselective intra-arterial infusion of papaverine hydrochloride. Thirty-seven vascular territories in 10 patients with symptomatic vasospasm were treated according to the following protocol. Percutaneous transluminal angioplasty was performed in two steps. First, a silicone balloon was used for dilation of the internal carotid artery and the proximal portions of the middle cerebral artery. A silicone leak balloon or Tracker-18 catheter was then introduced into or just proximal to the site of vasospasm not accessible to the angioplasty balloon catheter for superselective infusion of 0.2% papaverine. Thirty-four of 37 vascular territories were successfully dilated, and eight of 10 patients showed improvement in neurological function after the procedure. There were no serious side effects due to infusion of papaverine. It is essential to infuse the papaverine just proximal to the spastic vessels in order to deliver sufficient concentration of drug, and infusion should be carried out as early as possible before the artery loses its ability to return to a normal luminal size. Superselective intraarterial infusion of papaverine is an alternative method of treatment for symptomatic vasospasm.
Y Kaku; Y Yonekawa; T Tsukahara; K Kazekawa
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Journal of neurosurgery     Volume:  77     ISSN:  0022-3085     ISO Abbreviation:  J. Neurosurg.     Publication Date:  1992 Dec 
Date Detail:
Created Date:  1992-12-17     Completed Date:  1992-12-17     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  0253357     Medline TA:  J Neurosurg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  842-7     Citation Subset:  AIM; IM    
Department of Neurosurgery, National Cardiovascular Center, Osaka, Japan.
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MeSH Terms
Aged, 80 and over
Aneurysm, Ruptured / complications
Angioplasty, Balloon
Infusions, Intra-Arterial
Intracranial Aneurysm / complications
Ischemic Attack, Transient / drug therapy*,  etiology,  radiography
Middle Aged
Nicardipine / administration & dosage
Papaverine / administration & dosage*
Rupture, Spontaneous
Subarachnoid Hemorrhage / complications*
Urokinase-Type Plasminogen Activator / administration & dosage
Reg. No./Substance:
55985-32-5/Nicardipine; 58-74-2/Papaverine; EC Plasminogen Activator
Comment In:
J Neurosurg. 1993 Nov;79(5):797-8   [PMID:  8410265 ]

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