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Computational methods for visualizing and measuring verapamil efficacy for cerebral vasospasm.

Andrew Abumoussa1,2, Alex Flores3, James Ho4

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|November 3, 2020
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Summary

Real-time Digital Subtraction Angiography (DSA) perfusion analysis quantifies cerebral blood flow during interventions for cerebral vasospasm. This technique visualizes hypoperfused areas, aiding treatment decisions after aneurysmal subarachnoid hemorrhage.

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Area of Science:

  • Neurology
  • Interventional Radiology
  • Medical Imaging

Background:

  • Cerebral vasospasm following aneurysmal subarachnoid hemorrhage (aSAH) significantly impacts patient outcomes.
  • Current methods lack standardized, real-time objective assessments for interventional treatments of vasospasm.
  • Improving brain perfusion is critical in managing vasospasm.

Purpose of the Study:

  • To describe and evaluate real-time techniques for quantifying cerebral perfusion during interventional cerebral angiography.
  • To assess the utility of Digital Subtraction Angiography (DSA) perfusion analysis in managing vasospasm.

Main Methods:

  • Retrospective analysis of 39 consecutive cases treated for clinical vasospasm.
  • Quantification of perfusion metrics using DSA before and after verapamil administration.
  • Development of real-time perfusion analysis with colorized mapping of hypoperfused tissue.

Main Results:

  • DSA perfusion analysis successfully identified hypoperfused territories in real time.
  • Quantified exact changes in cerebral perfusion for individual cases and vascular territories.
  • Demonstrated the feasibility of real-time perfusion assessment during interventions.

Conclusions:

  • Real-time DSA perfusion analysis provides objective, visual, and quantitative data for treating cerebral vasospasm.
  • This technique may assist in real-time treatment adjustments and predicting therapeutic response.
  • Prospective studies are needed to validate these findings.