Korean J Radiol.
2015 Feb;16(1):180-187. 10.3348/kjr.2015.16.1.180.
Simultaneous Endovascular Treatment of Ruptured Cerebral Aneurysms and Vasospasm
- Affiliations
-
- 1Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul 110-744, Korea. hanmh@snuh.org
- 2Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul 110-744, Korea.
- 3Department of Neurosurgery, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang 431-796, Korea.
- 4Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 138-736, Korea.
- 5Department of Neurology, Stroke Center, Myongji Hospital, Goyang 412-270, Korea.
- 6Department of Neurosurgery, Sun Hospital, Daejeon 301-725, Korea.
- KMID: 2069998
- DOI: http://doi.org/10.3348/kjr.2015.16.1.180
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.
Keyword
MeSH Terms
-
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
Nimodipine
Vasodilator Agents
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