Distal cerebral vasospasm treatment following aneurysmal subarachnoid hemorrhage using the Comaneci device: technical feasibility and single-center preliminary results.
| Autor: | Thiery L; Department of Neuroradiology, APHM La Timone, Marseille, France louisthiery@hotmail.fr., Carle X; Department of Neuroradiology, APHM La Timone, Marseille, France., Testud B; Department of Neuroradiology, APHM La Timone, Marseille, France.; CEMEREM, Aix Marseille University, Marseille, France.; CNRS, CRMBM, Aix Marseille University, Marseille, France., Boulouis G; Department of Neuroradiology, CHRU Tours, Tours, France., Habert P; Department of Medical Imaging, APHM La Timone, Marseille, France.; LIIE, Aix Marseille University, Marseille, France.; CERIMED, Aix Marseille University, Marseille, France., Tradi F; Department of Medical Imaging, APHM La Timone, Marseille, France.; LIIE, Aix Marseille University, Marseille, France.; CERIMED, Aix Marseille University, Marseille, France., Reyre A; Department of Neuroradiology, APHM La Timone, Marseille, France., Lehmann P; Department of Neuroradiology, APHM La Timone, Marseille, France., Dory-Lautrec P; Department of Neuroradiology, APHM La Timone, Marseille, France., Stellmann JP; Department of Neuroradiology, APHM La Timone, Marseille, France.; CEMEREM, Aix Marseille University, Marseille, France.; CNRS, CRMBM, Aix Marseille University, Marseille, France., Girard N; Department of Neuroradiology, APHM La Timone, Marseille, France., Brunel H; Department of Neuroradiology, APHM La Timone, Marseille, France., Hak JF; Department of Neuroradiology, APHM La Timone, Marseille, France.; LIIE, Aix Marseille University, Marseille, France.; CERIMED, Aix Marseille University, Marseille, France. |
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| Jazyk: | angličtina |
| Zdroj: | Journal of neurointerventional surgery [J Neurointerv Surg] 2023 Apr; Vol. 15 (4), pp. 325-329. Date of Electronic Publication: 2022 May 18. |
| DOI: | 10.1136/neurintsurg-2022-018699 |
| Abstrakt: | Background: Balloon-assisted mechanical angioplasty for cerebral vasospasm following aneurysmal subarachnoid hemorrhage (aSAH) has a number of limitations, including transient occlusion of the spastic blood vessel. Comaneci is an FDA-approved device for temporary coil embolization assistance which has recently also been approved for the treatment of distal symptomatic refractory vasospasm. We aimed to report the feasibility, efficacy and safety of our experience with Comaneci angioplasty for refractory distal vasospasm (up to the second segment of the cerebral arteries) following aSAH. Methods: This is a retrospective analysis of a prospective series of 18 patients included between April 2019 and June 2021 with aSAH and symptomatic vasospasm refractory to medical therapy, who were treated using Comaneci-17-asssisted mechanical distal angioplasty. Immediate angiographic results, procedure-related complications, and clinical outcomes were assessed. Inter-rater reliability of the scores was determined using the intraclass correlation coefficient. Results: Comaneci-assisted distal angioplasty was performed in 18 patients, corresponding to 31 target arteries. All distal anterior segments were easily accessible with the Comaneci-17 device. Vasospasm improvement after Comaneci mechanical angioplasty was seen in 22 distal arteries (71%) (weighted Cohen's kappa (κ Conclusion: This initial experience suggests that distal mechanical angioplasty performed with the Comaneci-17 device for refractory vasospasm following aSAH seems to be safe, with good feasibility and efficacy. Competing Interests: Competing interests: XC and J-FH are consultants for educational work with Rapid Medical. (© Author(s) (or their employer(s)) 2023. No commercial re-use. See rights and permissions. Published by BMJ.) |
| Databáze: | MEDLINE |
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