Abstract 3353: Primary Transluminal Balloon Angioplasty for Symptomatic Cerebral Vasospasm in Subarachnoid Hemorrhage without Triple H Therapy.
Background and Purpose- Triple H therapy has been used to treat symptomatic cerebral vasospasm as a first line therapy, but its clinical validity of improving cerebral blood flow (CBF) is still controversial. This study was started to confirm clinical validity of early transluminal balloon angioplasty (TBA) as a primary treatment measure for specific symptomatic cerebral vasospasm without triple H therapy.
Methods- This retrospective analysis was performed in 17 patients with SAH who had TBA for symptomatic vasospasm after subarachnoid hemorrhage (SAH). Only the patients whose conscious levels were alert or drowsy after operation were included.
Results- Fifteen patients (88.2%) with 61 stenotic segments of vessels were conducted with TBA and IA-Nimo infusion together and two patients (11.8%) with 7 segments of vessels were conducted with TBA only. The recurrence cases were found in 2 patients (11.8%) with 4 segments (6.6%) after first endovascular treatment. TBA was conducted on 26 segments on distal artery such as A2, M2 and P2 in 12 patients and only 2 (7.7%) segment vessels were retreated. The excellent outcome in neurologically are found in 16 patients (94%) and 15 (88.2%) in angiographically.
Conclusion- Patients in SAH whose conscious level is alert or drowsy after operation, TBA can be considered first as a therapeutic option for treating symptomatic cerebral vasospasm without 3H therapy due to its instant effect and impact on improving CBF. Keywords: subarachnoid hemorrhage; cerebral vasospasm; transluminal Balloon Angioplasty
- © 2012 by American Heart Association, Inc.