Partial aortic obstruction improves cerebral perfusion and clinical symptoms in patients with symptomatic vasospasm.
OBJECTIVE
Stroke studies in animals showed that aortic obstruction increases cerebral blood flow (CBF) and reduces infarct size. In this study we evaluate the safety and efficacy of a device providing partial and transitory aortic obstruction.


METHODS
We report the results in 24 selected patients with symptomatic vasospasm by aneurysmal subarachnoid hemorrhage treated by partial and transitory aortic obstruction with a novel device (NeuroFlo, CoAxia, MN). Aneurysms were secured by coils prior to the procedure. We studied the adverse effects related to the aorta-obstructing device, and changes in CBF and neurological outcome.


RESULTS
Mean flow velocity increased in both middle cerebral arteries over 15%, and the score in the National Institute of Health Stroke Scale decreased >or=2 point in 20 patients (83%). During the procedure, three patients developed symptoms that were controlled. At 30 days follow-up, three patients had 6 points (unrelated death), three had 3 points, six had 1 point, and 12 had 0 points, in the modified Rankin scale.


CONCLUSIONS
Partial aortic obstruction was safe, the cerebral blood flow increased without inducing significant hypertension and the neurological defects improved in most of the patients. Efficacy with a better level of evidence will be determined by a randomized study.
Lylyk
Pedro
P
Department of Neurosurgery, Endovascular Neurosurgery and Interventional Neuroradiology, ENERI Clínica Médica Belgrano Buenos Aires, Argentina. plylyk@lylyk.com.ar
Vila
José F
JF
Miranda
Carlos
C
Ferrario
Angel
A
Romero
Ricardo
R
Cohen
José E
JE
D000328:Adult; D001157:Arterial Occlusive Diseases / Q000503:physiopathology* / Q000628:therapy*; D001794:Blood Pressure; D002560:Cerebrovascular Circulation; D005260:Female; D006801:Humans; D008875:Middle Aged; D018579:Patient Selection; D020301:Vasospasm, Intracranial / Q000209:etiology*