Endovascular treatment of cerebral vasospasm: vasodilators and angioplasty

Aditya S Pandey; Augusto E Elias; Neeraj Chaudhary; Byron G Thompson; Joseph J Gemmete

doi:10.1016/j.nic.2013.03.008

Endovascular treatment of cerebral vasospasm: vasodilators and angioplasty

Neuroimaging Clin N Am. 2013 Nov;23(4):593-604. doi: 10.1016/j.nic.2013.03.008. Epub 2013 May 24.

Authors

Aditya S Pandey¹, Augusto E Elias, Neeraj Chaudhary, Byron G Thompson, Joseph J Gemmete

Affiliation

¹ Division of Interventional Neuroradiology, Departments of Neurosurgery and Radiology, University of Michigan Hospitals, 1500 East Medical Center Drive, Ann Arbor, MI 48109-5030, USA.

PMID: 24156852
DOI: 10.1016/j.nic.2013.03.008

Abstract

Cerebral vasospasm following aneurysmal subarachnoid hemorrhage (SAH) is a delayed, reversible narrowing of the intracranial vasculature that occurs most commonly 4 to 14 days after aneurysmal SAH and can lead to permanent ischemic injury. Angiographic spasm occurs in up to 70% of patients following SAH, and approximately half become symptomatic. Estimates of patients who are disabled by vasospasm, or die because of it, range from 5% to 9%, with vasospasm accounting for 12% to 17% of all fatalities or cases of disability after SAH. This article discusses the multiple medical and endovascular therapies used to prevent or treat vasospasm.

Keywords: Balloon angioplasty; Mechanical and chemical angioplasty; SAH; Triple-H therapy; Vasospasm.

Publication types

Review

MeSH terms

Cerebral Revascularization / instrumentation*
Cerebral Revascularization / methods*
Combined Modality Therapy
Endovascular Procedures / instrumentation*
Endovascular Procedures / methods*
Humans
Infusions, Intra-Arterial
Neuroimaging / methods
Stents*
Surgery, Computer-Assisted / methods
Vasodilator Agents / administration & dosage*
Vasospasm, Intracranial / diagnosis
Vasospasm, Intracranial / surgery*

Substances

Vasodilator Agents