Endovascular treatment: balloon angioplasty versus nimodipine intra-arterial for medically refractory cerebral vasospasm following aneurysmal subarachnoid hemorrhage.
Cerebral vasospasm (CV) accounts significant morbimortality after aneurysmal subarachnoid hemorrhage. The objective of this study was to compare the clinical outcome of patients with CV treated by 2 endovascular procedures: intra-arterial nimodipine angioplasty (IANA) and balloon angioplasty (BA). Between 2008 and June 2011, we performed 22 IANA and 8 BA in 30 patients. The mean age was 44 years and 60% was female. In 17 patients, the treatment was clipping, whereas 13 underwent coil treatment. The CV was severe in 63%, moderate in 30%, and mild in 7%. Good outcome between 2 groups was similar (P = .36). The clinical outcome according to the subgroups of CV severity and modality treatment was equivalent (P = .22). Mortality at 3 months was 16% and 20% at 1 year. We did not find differences in the clinical outcome despite the fact that both techniques produce adequate angiographic resolution of CV.
Departamento de Terapia Endovascular, Instituto Nacional de Neurología y Neurología, Insurgentes Sur, Mexico. yola_aburto@yahoo.com.mx
Yolanda
Y
Aburto-Murrieta
Juan M
JM
Marquez-Romero
Dulce
D
Bonifacio-Delgadillo
Iván
I
López
B
B
Hernández-Curiel
D000328:Adult; D015901:Angiography, Digital Subtraction; D000800:Angioplasty, Balloon / Q000009:adverse effects / Q000401:mortality; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D007261:Infusions, Intra-Arterial; D002532:Intracranial Aneurysm / Q000150:complications* / Q000401:mortality; D008297:Male; D008800:Mexico; D008875:Middle Aged; D009553:Nimodipine / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013345:Subarachnoid Hemorrhage / Q000209:etiology* / Q000401:mortality; D013997:Time Factors; D016896:Treatment Outcome; D014665:Vasodilator Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D020301:Vasospasm, Intracranial / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000209:etiology / Q000401:mortality / Q000628:therapy*; D055815:Young Adult
D014665:Vasodilator Agents; D009553:Nimodipine