Safety and efficacy of balloon angioplasty of the anterior cerebral artery for vasospasm treatment after subarachnoid hemorrhage
Autor: | Victor A. Aletich, Sophia F. Shakur, Fady T. Charbel, Nauman S. Chaudhry, Jennifer L Orning, Sepideh Amin-Hanjani, Ali Alaraj |
---|---|
Rok vydání: | 2017 |
Předmět: |
Adult
Male medicine.medical_specialty Subarachnoid hemorrhage Anterior Cerebral Artery Computed Tomography Angiography medicine.medical_treatment Infarction Balloon 030218 nuclear medicine & medical imaging 03 medical and health sciences 0302 clinical medicine Angioplasty medicine.artery Anterior cerebral artery Humans Vasospasm Intracranial Medicine cardiovascular diseases Aged Retrospective Studies Aged 80 and over medicine.diagnostic_test business.industry Vasospasm Middle Aged Subarachnoid Hemorrhage medicine.disease Aneurysm Cerebral Angiography Surgery Anterior communicating artery Treatment Outcome cardiovascular system Female Patient Safety business Angioplasty Balloon 030217 neurology & neurosurgery Cerebral angiography |
Zdroj: | Interventional Neuroradiology. 23:372-377 |
ISSN: | 2385-2011 1591-0199 |
Popis: | Balloon angioplasty is often performed for symptomatic vasospasm following aneurysmal subarachnoid hemorrhage. Angioplasty of the anterior cerebral artery (ACA), however, is perceived to be a challenging endeavor and not routinely performed due to technical and safety concerns. Here, we evaluate the safety and efficacy of balloon angioplasty of the anterior cerebral artery for vasospasm treatment. Patients with vasospasm following subarachnoid hemorrhage who underwent balloon angioplasty at our institution between 2011 and 2016 were retrospectively reviewed. All ACA angioplasty segments were analyzed for pre- and post-angioplasty radiographic measurements. The degree of vasospasm was categorized as mild (50%), and relative change in caliber was measured following treatment. Clinical outcomes following treatment were also assessed. Among 17 patients, 82 total vessel segments and 35 ACA segments were treated with balloon angioplasty. Following angioplasty, 94% of segments had increased caliber. Neurological improvement was noted in 75% of awake patients. There were no intra-procedural complications, but two patients developed ACA territory infarction, despite angioplasty treatment. We demonstrate that balloon angioplasty of the ACA for vasospasm treatment is safe and effective. Thus, ACA angioplasty should be considered to treat vasospasm in symptomatic patients recalcitrant to vasodilation infusion therapy. |
Databáze: | OpenAIRE |
Externí odkaz: |