Balloon angioplasty for the treatment of vasospasm: results of first 50 cases

Neurosurgery
J M EskridgeH R Winn

Abstract

To report the results of the first 50 consecutive patients with vasospasm secondary to subarachnoid hemorrhage treated with balloon angioplasty after failure of medical management. Retrospective uncontrolled study of 50 consecutive patients treated with balloon angioplasty between February 1988 and July 1992. Forty-six had objective clinical deterioration despite maximal medical therapy, whereas four were treated on the basis of rapidly accelerating transcranial Doppler velocities and decreased regional blood perfusion detected by technetium-99m-exametazime brain single photon emission computed tomography. All patients had evidence of marked vasospasm demonstrated by angiography. Thirty-two (64%) and 46 (92%) patients underwent angioplasty within 12 and 18 hours, respectively. Of the patients with clinical evidence of vasospasm-induced ischemia, 28 (61%) showed sustained neurological improvement within 72 hours of angioplasty. Three (6%) patients deteriorated within 72 hours after angioplasty, with two (4%) patients dying immediately after angioplasty as a result of vessel rupture and the other patient's Glasgow Coma Scale score decreasing by 2. Two additional patients in poor condition with Hunt and Hess Grade V at the time of...Continue Reading

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Citations

Jan 8, 2000·Stroke; a Journal of Cerebral Circulation·S C Johnston
Feb 7, 2001·Brain : a Journal of Neurology·J van Gijn, G J Rinkel
Apr 19, 2008·Stroke; a Journal of Cerebral Circulation·Marike Zwienenberg-LeeUNKNOWN Balloon Prophylaxis for Aneurysmal Vasospasm (BPAV) Study Group
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Sep 6, 2011·Journal of Neurosurgery·Marc R Mayberg
Feb 28, 2017·Cerebrovascular Diseases·Jaiyoung RyuShawn C Shadden
Nov 22, 2017·Journal of Cerebrovascular and Endovascular Neurosurgery·Eun-Sung ParkSung-Don Kang
Mar 13, 2019·Frontiers in Neurology·Miriam WeissGerrit Alexander Schubert
Jul 20, 2019·AJNR. American Journal of Neuroradiology·M-A LabeyrieE Houdart
Jan 27, 2005·Neurosurgery·Kazuhiro TanakaEiji Kohmura
Oct 13, 2006·Neurosurgical Focus·Stefan A MindeaH Hunt Batjer
Oct 2, 2014·Journal of Neurosurgical Anesthesiology·Stanlies D'Souza
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Oct 21, 2006·Neurosurgery·Marike Zwienenberg-LeeJan Paul Muizelaar
Sep 1, 2006·The New England Journal of Medicine·Jonathan L BrismanDavid W Newell
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Jul 16, 2011·Neurocritical Care·Matthew M KimballUNKNOWN Participants in the International Multi-Disciplinary Consensus Conference on the Critical Care Management of Subarachnoid He
Jan 10, 2014·Neurosurgery·Ali AlarajVictor Aletich

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