title: Simultaneous endovascular treatment of ruptured cerebral aneurysms and vasospasm.
abstract: OBJECTIVE
  The management of patients with ruptured cerebral aneurysms and severe vasospasm is subject to considerable controversy. We intended to describe herein an endovascular technique for the simultaneous treatment of aneurysms and vasospasm.
  
  
  METHODS
  A series of 11 patients undergoing simultaneous endovascular treatment of ruptured aneurysms and vasospasm were reviewed. After placement of a guiding catheter within the proximal internal carotid artery for coil embolization, an infusion line of nimodipine was wired to one hub, and of a microcatheter was advanced through another hub (to select and deliver detachable coils). Nimodipine was then infused continuously during the coil embolization.
  
  
  RESULTS
  This technique was applied to 11 ruptured aneurysms accompanied by vasospasm (anterior communicating artery, 6 patients; internal carotid artery, 2 patients; posterior communicating and middle cerebral arteries, 1 patient each). Aneurysmal occlusion by coils and nimodipine-induced angioplasty were simultaneously achieved, resulting in excellent outcomes for all patients, and there were no procedure-related complications. Eight patients required repeated nimodipine infusions.
  
  
  CONCLUSIONS
  Our small series of patients suggests that the simultaneous endovascular management of ruptured cerebral aneurysms and vasospasm is a viable approach in patients presenting with subarachnoid hemorrhage and severe vasospasm.
authors.affiliation: Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul 110-744, Korea.
authors.forename: Young Dae
authors.initials: YD
authors.lastname: Cho
authors.affiliation: Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul 110-744, Korea. ; Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul 110-744, Korea.
authors.forename: Moon Hee
authors.initials: MH
authors.lastname: Han
authors.affiliation: Department of Neurosurgery, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang 431-796, Korea.
authors.forename: Jun Hyong
authors.initials: JH
authors.lastname: Ahn
authors.affiliation: Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 138-736, Korea.
authors.forename: Seung Chai
authors.initials: SC
authors.lastname: Jung
authors.affiliation: Department of Neurology, Stroke Center, Myongji Hospital, Goyang 412-270, Korea.
authors.forename: Chang Hun
authors.initials: CH
authors.lastname: Kim
authors.affiliation: Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul 110-744, Korea.
authors.forename: Hyun-Seung
authors.initials: HS
authors.lastname: Kang
authors.affiliation: Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul 110-744, Korea.
authors.forename: Jeong Eun
authors.initials: JE
authors.lastname: Kim
authors.affiliation: Department of Neurosurgery, Sun Hospital, Daejeon 301-725, Korea.
authors.forename: Jeong Wook
authors.initials: JW
authors.lastname: Lim
mesh_terms: D000328:Adult; D000368:Aged; D017542:Aneurysm, Ruptured / Q000628:therapy*; D002343:Carotid Artery, Internal / Q000000981:diagnostic imaging; D004621:Embolization, Therapeutic; D057510:Endovascular Procedures; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000628:therapy*; D018810:Magnetic Resonance Angiography; D008297:Male; D008875:Middle Aged; D009553:Nimodipine / Q000627:therapeutic use; D011859:Radiography; D012189:Retrospective Studies; D014665:Vasodilator Agents / Q000627:therapeutic use; D020301:Vasospasm, Intracranial / Q000628:therapy*
chemical_list: D014665:Vasodilator Agents; D009553:Nimodipine
keywords: Aneurysm; Angioplasty; Coil embolization; Vasospasm