Introduction/Purpose Cerebral vasospasm is a major cause of morbidity and mortality associated with subarachnoid hemorrhage (SAH). Vasospasm refractory to medical therapy is traditionally treated with percutaneous transluminal balloon angioplasty (PTA) and/or vasodilator infusion. Side effects of PTA included, but were not limited to, vessel rupture while vasodilator infusion often is temporary and requires retreatment. Vesalio NEVA VS is a novel cerebral dilatation device, which recently received FDA’s approval for treatment of symptomatic cerebral vasospasm. We report our initial clinical experience with NEVA VS device.

Materials and Methods A Total of 5 patients were treated for refractory symptomatic cerebral vasospasm following SAH with utilization of NEVA VS. Among those patients, four had unilateral MCA spasm and one patient had ICA spasm. All patients had preoperative CTA and DSA confirming more than 50% flow limiting spasm in the treated artery. Three patients received vasodilator infusions (Verapamil and or Milrinone) prior to deployment of NEVA VS but failed to respond. In four patients, single deployment (un-shield and re-shield technique) was utilized. In one patient, a second deployment with technique modification as ‘un-shield and drag out’ was utilized. Duration of deployment was recorded in all cases. All patients were studied with delayed CTA within a week after initial treatment and one patient was studied with repeat DSA within 24 hours.

Results In all cases, marked improvements in angiographical spasm were noticed immediately after treatment with NEVA VS. The duration of deployment was variable between 2 to 5 min. The vasospasm resolution was permanent in all five patients and did not require retreatment in the same vessel. There were no complications related to this treatment.

Conclusion Vesalio NEVA VS device appears to be safe and effective with at least prolonged or possible permanent resolution of refractory cerebral vasospasm. ‘Un-shield and drag out’ technique can be used as an alternative to ‘un-shield and re-shield’ technique.

Disclosures A. Grigorian: 4; C; Vesalio. R. Gupta: 2; C; Vesalio.