title: [Cerebral aneurysm occlusion in patients with critical vasospasm in acute period of disease].
abstract: Aneurismal hemorrhages are often complicated by vasospasm (VS). The pharmacological vasodilatation using during endovascular operations allows making the occlusion on the peak of vasospasm to prevent the repeated aneurysmal rupture. An advantage of the superselective introduction (CI) consists in creation of the high concentration of medical substance in the damage segment that allows applying biologically highly active preparations, thus reducing their general influence on a body. Except pharmacological influence, CI causes considerable reflex stimulation of a blood flow owing to the direct irritation of sympathetic nervous system angioreceptors. 153 patients with aneurysms were operated on a vasospasm peak; CI was applied in 24 cases. The severity of the condition defined by WFNS: I - 32 (20,9 %), II - 41 (26,8 %), III - 49 (32 %), IV - 30 (19,6 %), V - 1 (0,7 %). All patients were in the acute period of a hemorrhage (prior to 21 days). CI was spent in the presence of a critical vasospasm (> or = 70 %). Results estimated by a principle of satisfactory dilatation (sufficient restoring of a vessel lumen for operating system carrying out)--22 (92 %) and unsatisfactory dilatation--2 (8%) cases. Some features were found: extension of all capillary network, absence of any ischemic or hemorrhage complications, artery expansion in 5-6 min after infusion, dilatation was disagreed with a possible physiological artery lumen, extension of all artery, instead of a local vassel segment, absence of vasospasm recurrence throughout the subsequent 1-1,5 h. Method of the medical substance superselective introduction directly in to the constricted artery allows to conduct endovascular occlusion of aneurysms on a peak of the critical vasospasm.
authors.forename: D V
authors.initials: DV
authors.lastname: Shchehlov
mesh_terms: D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000150:complications*; D008297:Male; D014652:Vascular Diseases / Q000150:complications*; D020301:Vasospasm, Intracranial / Q000150:complications*