J Korean Neurosurg Soc.  2011 Mar;49(3):157-162.

Safety and Efficacy of Transluminal Balloon Angioplasty Using a Compliant Balloon for Severe Cerebral Vasospasm after an Aneurysmal Subarachnoid Hemorrhage

• Choi BJ
• Lee TH
• Lee JI
• Ko JK
• Park HS
• Choi CH

Abstract

OBJECTIVE
Vasospasm of cerebral vessels remains a major source of morbidity and mortality after an aneurysmal subarachnoid hemorrhage (SAH). The purpose of this study was to evaluate the safety and efficacy of transluminal balloon angioplasty (TBA) for SAH-induced vasospasm.
METHODS
Eleven 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
TBA using Hyper-Glide or Hyper-Form balloons (MicroTherapeutics, Irvine, CA) 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 (ACA), including the A1 (66%), A2 (66%), and A3 segments (100%). Vessel diameters significantly increased after TBA. There were no cases of vessel rupture or thromboembolic complications. GCS at one day after TBA showed an improvement 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.

Keyword

Transluminal balloon angioplasty; Vasospasm; Subarachnoid hemorrhage; Endovascular procedure

MeSH Terms

Aneurysm
Angiography, Digital Subtraction
Angioplasty, Balloon
Anterior Cerebral Artery
Arteries
Basilar Artery
Carotid Artery, Internal
Endovascular Procedures
Glycosaminoglycans
Humans
Middle Cerebral Artery
Rupture
Subarachnoid Hemorrhage
Vasospasm, Intracranial
Vertebral Artery
Glycosaminoglycans