Effect of balloon angioplasty on high grade symptomatic vasospasm after subarachnoid hemorrhage

Yasunobu Fujii, Akira Takahashi, Takashi Yoshimoto

Research output: Contribution to journalArticlepeer-review

32 Citations (Scopus)

Abstract

Of 455 cases of ruptured intracranial aneurysm treated with radical surgery from January 1987 to March 1992, 19 cases with high grade symptomatic vasospasm were treated by percutaneous transluminal balloon angioplasty (PTA). The indication for PTA was high grade symptomatic vasospasm which does not respond to conservative medical treatment. Of the 36 segments of vasospastic arteries, severe vasospams (angiographical constriction more than 50% of diameter on admission) was observed in 67%. PTA dialted these vasospastic arteries significantly (diameter of more than 75% of diameter on admission) in 83%. Follow up angiography revealed neither recurrence of vasospasm nor chronic atherosclerotic changes. Clinical improvement within 24 hours after PTA was observed in 63% of cases (7 of 17 cases with consciousness disturbance, 5 of 16 cases with motor weakness and one of 7 cases with aphasia). Outcomes at the time of discharge were excellent in 10 cases, good in 3, fair in 4, and lethal in 2. SPECT study before and after PTA confirmed improvement of cerebral blood flow in 3 out of 5 cases investigated. PTA for high grade symptomatic vasospasm after subarachnoid hemorrhage is considered an effective treatment method for the patient who does not respond to medical therapy. Immediate improvement of angiographical and clinical findings were frequently observed immediately after PTA. Exact indication and timing of PTA should be postulated after much more cases have been treated with this methal.

Original languageEnglish
Pages (from-to)7-13
Number of pages7
JournalNeurosurgical Review
Volume18
Issue number1
DOIs
Publication statusPublished - 1995 Mar 1

Keywords

  • Aneurysm
  • angioplasty
  • balloon catheter, intravascular surgery
  • subarachnoid hemorrhage
  • vasospasm

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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