Purpose Vasospasm of cerebral vessels remains a major source of morbidity and mortality after an aneurysmal subarachnoid hemorrhage. The purpose of this study was to evaluate the safety and efficacy of transluminal balloon angioplasty (TBA) for subarachnoid hemorrhage-induced vasospasm.
Materials and Methods 11 patients with an angiographically confirmed significant vasospasm (>50% vessel narrowing and clinical deterioration) were studied. A total of 54 vessel segments with significant vasospasm were treated by TBA. Digital subtraction angiography was used to confirm the presence of vasospasm, and TBA was performed to dilate vasospastic arteries. Medical and angiographic reports were reviewed to determine technical efficacy and for procedural complications.
Results Balloon angioplasty using Hyper-Glide or Hyper-Form balloons (MicroTherapeutics, Irvine, California, USA) was successfully accomplished in 88.9% vasospastic segments (48 of 54), namely, in the distal internal carotid artery (100%, n=7), the middle cerebral artery (100%), including the M1 (n=10), M2 (n=10), and M3 segments (n=4), in the vertebral artery (100%, n=2), basilar artery (100%, n=1), and in the anterior cerebral artery, including the A1 (66%), A2 (66%), and A3 segments (100%). Vessel diameters significantly increased after TBA. No vessel rupture or thromboembolic complications occurred. GCS at 1st day after TBA is improved in all patients except one.
Conclusion This study suggests that TBA using Hyper-Glide or Hyper-Form balloons is a safe and effective treatment for subarachnoid hemorrhage-induced cerebral vasospasm.
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