Treatment of Cerebral Vasospasm after Aneurysmal Subarachnoid Hemorrhage Using the Compliant Manually Adjustable Mesh Comaneci.

Autor: Guenego A; Interventional Neuroradiology Department Hôpital Universitaire de Bruxelles (HUB), Brussels, Belgium., Salim HA; Department of Radiology, Division of Neuroradiology, Johns Hopkins Medical Center, Baltimore, Maryland, USA., Wang M; Interventional Neuroradiology Department Hôpital Universitaire de Bruxelles (HUB), Brussels, Belgium., Heit JJ; Departments of Radiology and Neurosurgery, Stanford Medical Center, Palo Alto, California, United States of America., Sadeghi N; Department of Radiology and Neuroradiology, Hôpital Universitaire de Bruxelles (HUB), Brussels, Belgium., Ligot N; Department of Neurology, Hôpital Universitaire de Bruxelles (HUB), Brussels, Belgium., Lolli V; Department of Radiology and Neuroradiology, Hôpital Universitaire de Bruxelles (HUB), Brussels, Belgium., Tannouri F; Department of Interventional Radiology, Hôpital Universitaire de Bruxelles (HUB), Brussels, Belgium., Taccone FS; Department of Intensive Care, Hôpital Universitaire de Bruxelles (HUB), Route de Lennik, 808, 1070 Brussels, Belgium., Lubicz B; Interventional Neuroradiology Department Hôpital Universitaire de Bruxelles (HUB), Brussels, Belgium.
Jazyk: angličtina
Zdroj: Journal of the Belgian Society of Radiology [J Belg Soc Radiol] 2024 Oct 17; Vol. 108 (1), pp. 89. Date of Electronic Publication: 2024 Oct 17 (Print Publication: 2024).
DOI: 10.5334/jbsr.3714
Abstrakt: Background and purpose: Cerebral vasospasm (CV) following aneurysmal subarachnoid hemorrhage (aSAH) may lead to morbidity and mortality. Endovascular mechanical angioplasty may be performed if symptomatic CV is refractory to noninvasive medical management. Compliant and noncompliant balloons and manually adjustable mesh may be used in this indication. We describe our initial experience with the Comaneci (Rapid Medical, Yokneam, Israel) in cerebral vasospasm treatment following aSAH. Methods: All patients included in the prospective observational SAVEBRAIN PWI (NCT05276934 on clinicaltrial.gov) study who underwent cerebral angioplasty using the Comaneci device for the treatment of medically refractory and symptomatic CV after aSAH were identified. Patient demographic information, procedural details, and outcomes were obtained from electronic medical records. Results: Between February 2022 and June 2023, seven consecutive patients underwent CV treatment with the Comaneci. Angioplasty of 37 arterial segments (supraclinoid internal carotid artery, A1, A2, and A3 segments of the anterior cerebral artery and M1 and M2 segments of the middle cerebral artery) was attempted, and 35/37 (95%) were performed. The vessel diameter improved significantly following angioplasty (+64%), while brain hypoperfusion decreased (-45% of the mean T Max ). There was no long-term clinical complication, and 6% per-procedural complications occurred. Conclusions: The Comaneci is effective in the treatment of cerebral vasospasm following aSAH, bringing a new device in the armamentarium of the neurointerventionalist to perform intracranial angioplasty.
Competing Interests: The authors have no competing interests to declare.
(Copyright: © 2024 The Author(s).)
Databáze: MEDLINE
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