Angiographic evaluation of the effect of intra-arterial milrinone therapy in patients with vasospasm from aneurysmal subarachnoid hemorrhage.
BACKGROUND
Several methods have been used to treat cerebral vasospasm, which is a major cause of morbidity and mortality in patients with aneurysmal subarachnoid hemorrhage (SAH). Here, we examined the effectiveness and safety of intra-arterial injection of milrinone for the treatment of vasospasm.


METHODS
Consecutive patients with angiographically confirmed vasospasm received intra-arterial milrinone between January 2006 and December 2007. The improvement in diameter of vessel (in millimeters) following treatment was assessed by paired t test for statistical significance. The angiographic improvement of supraclinoid internal carotid artery, M1 segment of middle cerebral artery, and A1 and A2 segment of anterior cerebral artery was compared with the modified Rankin score of the patients at discharge.


RESULTS
A total of 15 milrinone treatments were performed in 14 patients (11 females and 3 males) with mean age of 52.7 years (31-68 years). There was significant angiographic improvement after milrinone therapy (p < 0.0001).


CONCLUSIONS
Intra-arterial milrinone was a safe and effective treatment of cerebral vasospasm following aneurysmal SAH.
Shankar
Jai Jai Shiva
JJ
Department of Medical Imaging, The Ottawa Hospital, Ottawa, ON, Canada.
dos Santos
Marlise P
MP
Deus-Silva
Leonardo
L
Lum
Cheemun
C
D000328:Adult; D000368:Aged; D002533:Cerebral Angiography / Q000379:methods*; D005260:Female; D006801:Humans; D007269:Injections, Intra-Arterial; D008297:Male; D008875:Middle Aged; D020105:Milrinone / Q000008:administration & dosage* / Q000009:adverse effects; D013345:Subarachnoid Hemorrhage / Q000150:complications / Q000000981:diagnostic imaging* / Q000188:drug therapy*; D016896:Treatment Outcome; D014665:Vasodilator Agents / Q000008:administration & dosage / Q000009:adverse effects; D020301:Vasospasm, Intracranial / Q000000981:diagnostic imaging* / Q000188:drug therapy* / Q000209:etiology
D014665:Vasodilator Agents; D020105:Milrinone