Simultaneous Endovascular Treatment of Ruptured Cerebral Aneurysms and Vasospasm.
10.3348/kjr.2015.16.1.180
- Author:
Young Dae CHO
1
;
Moon Hee HAN
;
Jun Hyong AHN
;
Seung Chai JUNG
;
Chang Hun KIM
;
Hyun Seung KANG
;
Jeong Eun KIM
;
Jeong Wook LIM
Author Information
1. Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul 110-744, Korea. hanmh@snuh.org
- Publication Type:Brief Communication
- Keywords:
Aneurysm;
Vasospasm;
Coil embolization;
Angioplasty
- MeSH:
Adult;
Aged;
Aneurysm, Ruptured/*therapy;
Carotid Artery, Internal/radiography;
Embolization, Therapeutic;
*Endovascular Procedures;
Female;
Humans;
Intracranial Aneurysm/*therapy;
Magnetic Resonance Angiography;
Male;
Middle Aged;
Nimodipine/therapeutic use;
Retrospective Studies;
Vasodilator Agents/therapeutic use;
Vasospasm, Intracranial/*therapy
- From:Korean Journal of Radiology
2015;16(1):180-187
- CountryRepublic of Korea
- Language:English
-
Abstract:
OBJECTIVE: The management of patients with ruptured cerebral aneurysms and severe vasospasm is subject to considerable controversy. We intended to describe herein an endovascular technique for the simultaneous treatment of aneurysms and vasospasm. MATERIALS AND METHODS: A series of 11 patients undergoing simultaneous endovascular treatment of ruptured aneurysms and vasospasm were reviewed. After placement of a guiding catheter within the proximal internal carotid artery for coil embolization, an infusion line of nimodipine was wired to one hub, and of a microcatheter was advanced through another hub (to select and deliver detachable coils). Nimodipine was then infused continuously during the coil embolization. RESULTS: This technique was applied to 11 ruptured aneurysms accompanied by vasospasm (anterior communicating artery, 6 patients; internal carotid artery, 2 patients; posterior communicating and middle cerebral arteries, 1 patient each). Aneurysmal occlusion by coils and nimodipine-induced angioplasty were simultaneously achieved, resulting in excellent outcomes for all patients, and there were no procedure-related complications. Eight patients required repeated nimodipine infusions. CONCLUSION: Our small series of patients suggests that the simultaneous endovascular management of ruptured cerebral aneurysms and vasospasm is a viable approach in patients presenting with subarachnoid hemorrhage and severe vasospasm.
