JOURNAL ARTICLE
Add like
Add dislike
Add to saved papers

Novel Treatment of Cerebral Vasospasm Using Solitaire Stent Retriever-assisted Angioplasty: A Case Series.

World Neurosurgery 2019 December 25
BACKGROUND: Endovascular procedures such as intra-arterial (IA) vasodilator injection and balloon angioplasty are used to treat medically refractory cerebral vasospasm. The effects of IA therapy may be short-lived and thus require multiple treatments. Balloon angioplasty also has limitations, including transient occlusion of the spastic blood vessel, possible endothelial injury, and limited access to proximal vessels. We aim to demonstrate a novel technique using stent retriever for the management of medically refractory vasospasm, especially in distal vessels. Compared to balloon angioplasty, stent retrievers provide a passive, self-limiting expansion of blood vessels. Other benefits over balloon angioplasty include: a) ability to simultaneously inject IA vasodilators, b) limited contact and damage to vessel wall, c) non-occlusive expansion, and d) technical ease.

METHODS: Fourteen blood vessels from six patients with symptomatic vasospasm after subarachnoid hemorrhage were identified. 5mg of IA vasodilator medication was injected into the vasospastic segments without radiographic improvement in vessel diameter and blood flow. The stent retriever was deployed for 2-5 minutes in each vasospastic segment.

RESULTS: Distal anterior and posterior circulation segments were easily accessible with the stent retriever system. It resulted in improved vessel diameter and blood flow with subsequent improvement in neurological exam. All patients demonstrated radiographic resolution of vasospasm. No procedural-related complications were noted.

CONCLUSION: We demonstrate the safety and efficacy of a novel technique for the treatment of medically refractory cerebral vasospasm using stent retriever angioplasty in distal vessels. Stent angioplasty can be utilized as an additional tool in the management of subarachnoid hemorrhage-induced cerebral vasospasm.

Full text links

For the best experience, use the Read mobile app

Group 7SearchHeart failure treatmentPapersTopicsCollectionsEffects of Sodium-Glucose Cotransporter 2 Inhibitors for the Treatment of Patients With Heart Failure Importance: Only 1 class of glucose-lowering agents-sodium-glucose cotransporter 2 (SGLT2) inhibitors-has been reported to decrease the risk of cardiovascular events primarily by reducingSeptember 1, 2017: JAMA CardiologyAssociations of albuminuria in patients with chronic heart failure: findings in the ALiskiren Observation of heart Failure Treatment study.CONCLUSIONS: Increased UACR is common in patients with heart failure, including non-diabetics. Urinary albumin creatininineJul, 2011: European Journal of Heart FailureRandomized Controlled TrialEffects of Liraglutide on Clinical Stability Among Patients With Advanced Heart Failure and Reduced Ejection Fraction: A Randomized Clinical Trial.Review

Get seemless 1-tap access through your institution/university

For the best experience, use the Read mobile app

Read by QxMD is copyright © 2021 QxMD Software Inc. All rights reserved. By using this service, you agree to our terms of use and privacy policy.

Get seemless 1-tap access through your institution/university

For the best experience, use the Read mobile app