Endovascular therapy for aneurysmal vasospasm

Endovascular treatment of cerebral vasospasm induced by subarachnoid hemorrhage has become a useful therapy. The two main treatments that have been used are balloon angioplasty and intra-arterial papaverine infusion. Both treatments have been shown to reverse subarachnoid hemorrhage-induced vascular spasm, increase cerebral blood flow and improve delayed ischemic neurologic deficits induced by vasospasm. Balloon angioplasty is superior to papaverine for treatment of proximal vessel vasospasm by virtue of a more sustained effect on the vessels. Papaverine can be useful as an adjunct to balloon angioplasty and also for the treatment of distal vessels that are not accessible for balloon angioplasty.