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Transluminal balloon angioplasty for symptomatic distal vasospasm refractory to medical therapy in patients with aneurysmal subarachnoid hemorrhage.
MedLine Citation:
PMID:  21368694     Owner:  NLM     Status:  Publisher    
BACKGROUND:: Cerebral vasospasm (VSP) is a major cause of morbidity and mortality associated with subarachnoid hemorrhage (SAH). The current endovascular paradigm for vasospasm refractory to medical therapy is to perform angioplasty for proximal vessel VSP, and vasodilator infusion for distal vessel VSP. OBJECTIVE:: The authors report their experience of a large series of balloon angioplasty for distal VSP refractory to medical therapy in patients with aneurysmal SAH. METHODS:: Retrospective series of 32 patients with SAH and symptomatic VSP refractory to medical therapy who were treated with balloon angioplasty for distal vessel VSP. Immediate angiographic results, procedure related complications, and clinical outcomes were assessed. RESULTS:: From September 2001 to January 2010, 32 patients with symptomatic vasospasm refractory to medical therapy underwent angioplasty for distal arterial vasospasm. There were 26 women (81.3%), aged from 29 to 67 years. A total of 175 vessels were angioplastied (95 proximal and 80 distal). The only complication was due to rupture of an incompletely clipped aneurysm that was treated by immediate coiling and did not result in any clinical worsening. Repeated treatment was needed for 6 arteries (6/80=7.5%). There was no procedure related symptomatic complication. Good outcomes (mRS <2) were observed in 23/28 (82.1%) patients with follow-up. CONCLUSION:: Balloon angioplasty for distal VSP is safe, effective, and decreases the need for repeated intra-arterial treatments seen with infusion of vasodilator.
Alejandro Santillan; Jared Knopman; Walter Zink; Athos Patsalides; Y Pierre Gobin
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-2-26
Journal Detail:
Title:  Neurosurgery     Volume:  -     ISSN:  1524-4040     ISO Abbreviation:  -     Publication Date:  2011 Feb 
Date Detail:
Created Date:  2011-3-3     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7802914     Medline TA:  Neurosurgery     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Division of Interventional Neuroradiology, Department of Neurological Surgery, New York, Presbyterian Hospital, Weill Cornell Medical Center, New York, NY.
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