Neurointerventional treatment of vasospasm.
OBJECTIVE
To review the historical development and current status of endovascular techniques used in the treatment of symptomatic vasospasm following aneurysmal subarachnoid hemorrhage.


METHODS
This article summarizes the relevant literature on neurointerventional therapy for vasospasm, namely instillation of intraarterial medication (papaverine, nicardipine, verapamil) and transluminal balloon angioplasty. The authors synthesize the available literature with their own experience using the various endovascular modalities to treat vasospasm at high volume cerebrovascular centers.


METHODS
Indications for the use of neurointerventional therapy as well as a summary of the technique for transluminal angioplasty to treat vasospasm as employed by the authors is described.


CONCLUSIONS
Neurointerventional treatment of vasospasm following aneurysmal hemorrhage has been proven to be a safe and successful technique for those patients suffering symptomatic vasospasm refractory to medical management. The techniques contunue to undergo refinement as endovascular technology advances. We currently favor the use of balloon angioplasty over intraarterial antispasmotics due to the increased durability and long-lasting effects of the former and lower risk profile.
Brisman
Jonathan L
JL
Department of Cerebrovascular and Endovascular Neurosurgery, New Jersey Neuroscience Institute, Edison, NJ 08818, USA. jbrisman@solarishs.org
Eskridge
Joseph M
JM
Newell
David W
DW
D000800:Angioplasty, Balloon / Q000379:methods* / Q000639:trends; D000818:Animals; D002536:Cerebral Arteries / Q000187:drug effects / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D007261:Infusions, Intra-Arterial / Q000379:methods / Q000592:standards; D013345:Subarachnoid Hemorrhage / Q000150:complications*; D016896:Treatment Outcome; D014661:Vasoconstriction / Q000187:drug effects / Q000502:physiology; D014665:Vasodilator Agents / Q000627:therapeutic use; D020301:Vasospasm, Intracranial / Q000503:physiopathology* / Q000628:therapy*
D014665:Vasodilator Agents