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Mechanical treatment of vasospasm
Raqeeb Haque1, Christopher P Kellner, Ricardo J Komotar
1Department of Neurological Surgery, Columbia University, College of Physicians and Surgeons, Neurological Institute of New York, New York 10032, USA.
Neurological Research
|August 8, 2009
Summary
Mechanical interventions for cerebral vasospasm (CV) have advanced significantly. While endovascular techniques supplement medical therapy, CV still impacts outcomes after aneurysmal subarachnoid hemorrhage (aSAH).
Area of Science:
- Neurology
- Neurosurgery
- Interventional Radiology
Background:
- Cerebral vasospasm (CV) is a critical complication following aneurysmal subarachnoid hemorrhage (aSAH).
- Understanding CV pathophysiology has led to evolving treatment strategies over the past five decades.
Purpose of the Study:
- To review the rationale for mechanical interventions in CV.
- To evaluate the efficacy and complications of various mechanical treatment options for CV.
Main Methods:
- Literature review focusing on mechanical treatments for CV.
- Analysis of balloon angioplasty, intra-arterial drug infusion, and intra-aortic balloon counterpulsation.
- Discussion of epidemiology, pathophysiology, technique, outcomes, timing, and complications for each method.
Main Results:
- Endovascular techniques, including balloon angioplasty and intra-arterial drug infusion, have emerged as crucial adjuncts to medical management in the last 20 years.
- These techniques supplement established therapies for managing CV.
Conclusions:
- Cerebral vasospasm continues to be a significant factor in poor outcomes post-aSAH.
- Further refinement of current endovascular strategies and development of novel treatments are essential for improving patient outcomes.
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