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Simultaneous endovascular treatment of ruptured cerebral aneurysms and vasospasm.

Cho YD, Han MH, Ahn JH, Jung SC, Kim CH, Kang HS, Kim JE, Lim JW - Korean J Radiol (2015)

Bottom Line: 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.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul 110-744, Korea.

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.

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Guiding catheter hub system for simultaneous management of ruptured aneurysm and vasospasm.
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Figure 1: Guiding catheter hub system for simultaneous management of ruptured aneurysm and vasospasm.

Mentions: After placement of a guiding catheter in the proximal internal carotid artery (ICA) for coil embolization, an infusion line of nimodipine was wired to a hub of the guiding catheter. A microcatheter to deliver the coils was then advanced into the guiding catheter through a second hub. Nimodipine was infused continuously through the guiding catheter during the coil embolization procedure, as illustrated in Figure 1.


Simultaneous endovascular treatment of ruptured cerebral aneurysms and vasospasm.

Cho YD, Han MH, Ahn JH, Jung SC, Kim CH, Kang HS, Kim JE, Lim JW - Korean J Radiol (2015)

Guiding catheter hub system for simultaneous management of ruptured aneurysm and vasospasm.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4296268&req=5

Figure 1: Guiding catheter hub system for simultaneous management of ruptured aneurysm and vasospasm.
Mentions: After placement of a guiding catheter in the proximal internal carotid artery (ICA) for coil embolization, an infusion line of nimodipine was wired to a hub of the guiding catheter. A microcatheter to deliver the coils was then advanced into the guiding catheter through a second hub. Nimodipine was infused continuously through the guiding catheter during the coil embolization procedure, as illustrated in Figure 1.

Bottom Line: 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.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul 110-744, Korea.

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.

Show MeSH
Related in: MedlinePlus