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Journal of Korean Neurosurgical Society > Volume 49(3); 2011 > Article
Journal of Korean Neurosurgical Society 2011;49(3): 157-162.
doi: https://doi.org/10.3340/jkns.2011.49.3.157
Safety and Efficacy of Transluminal Balloon Angioplasty Using a Compliant Balloon for Severe Cerebral Vasospasm after an Aneurysmal Subarachnoid Hemorrhage.
Beom Jin Choi, Tae Hong Lee, Jae Il Lee, Jun Kyeung Ko, Hwa Seung Park, Chang Hwa Choi
1Department of Neurosurgery, Wallace Memorial Baptist Hospital, Busan, Korea.
2Department of Diagnostic Radiology, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Korea. drcello@pusan.ac.kr
3Department of Neurosurgery, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Korea.
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.
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.
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.
This study suggests that TBA using Hyper-Glide or Hyper-Form balloons is a safe and effective treatment for subarachnoid hemorrhage-induced cerebral vasospasm.
Key Words: Transluminal balloon angioplasty; Vasospasm; Subarachnoid hemorrhage; Endovascular procedure
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