Document Detail


The effect of endovascular therapy for cerebral arterial spasm, its limitation and pitfalls.
MedLine Citation:
PMID:  9143589     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: The effect of endovascular treatment for vasospasm was investigated by analysing the results of patients treated in Wakayama City in 1994. MATERIALS AND METHODS: Ninety nine patients with ruptured cerebral aneurysms, who survived more than one week and were treated in Wakayama City in 1994, were studied. Twenty five patients caused symptomatic vasospasm and 25 were treated by endovascular therapy, percutaneous transluminal angioplasty (PTA) and/or intra-arterial papaverine infusion (IAP). PTA was performed for proximal vasospasm which located in the main arterial trunk, such as ICA, M1, BA (n = 3). IAP was chosen for distal vasospasm which located mainly in the M2, A1, A2 (n = 12). PTA and/or IAP was performed for diffuse vasospasm which located in proximal and distal arteries (n = 10). RESULTS: In the proximal vasospasm group, all patients were good to moderately disabled on the Glasgow outcome scale (GOS). In the distal vasospasm group, 8 patients were good to moderately disabled, and 4 patients were severely disabled. The overall results were as follows: 17 (68%), good to moderately disabled, 4 (16%), severely disabled, 4 (16%), dead. The morbidity and mortality rate was 8/25 (32%) in symptomatic spasm group. CONCLUSION: PTA was very effective especially for proximal vasospasm, but IAP was not always effective for distal or diffuse vasospasm. Diffuse vasospasm revealed a high mortality rate in spite of the endovascular therapy.
Authors:
T Terada; Y Kinoshita; H Yokote; M Tsuura; K Nakai; T Itakura; G Hyotani; T Kuriyama; Y Naka; T Kido
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Publication Detail:
Type:  Case Reports; Comparative Study; Journal Article    
Journal Detail:
Title:  Acta neurochirurgica     Volume:  139     ISSN:  0001-6268     ISO Abbreviation:  Acta Neurochir (Wien)     Publication Date:  1997  
Date Detail:
Created Date:  1997-07-28     Completed Date:  1997-07-28     Revised Date:  2009-11-11    
Medline Journal Info:
Nlm Unique ID:  0151000     Medline TA:  Acta Neurochir (Wien)     Country:  AUSTRIA    
Other Details:
Languages:  eng     Pagination:  227-34     Citation Subset:  IM    
Affiliation:
Department of Neurological Surgery, Wakayama Medical College, Japan.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aneurysm, Ruptured / mortality,  radiography,  surgery*
Angioplasty, Balloon*
Cerebral Angiography
Disability Evaluation
Female
Follow-Up Studies
Humans
Intracranial Aneurysm / mortality,  radiography,  surgery*
Ischemic Attack, Transient / mortality,  radiography,  therapy*
Male
Middle Aged
Neurologic Examination
Papaverine / administration & dosage*,  adverse effects
Postoperative Complications / mortality,  radiography,  therapy*
Subarachnoid Hemorrhage / mortality,  radiography,  surgery*
Survival Rate
Vasodilator Agents / administration & dosage*,  adverse effects
Chemical
Reg. No./Substance:
0/Vasodilator Agents; 58-74-2/Papaverine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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