Comparison of balloon angioplasty and papaverine infusion for the treatment of vasospasm following aneurysmal subarachnoid hemorrhage

Object. The purpose of this study was to test the hypothesis that balloon angioplasty is superior to papaverine infusion for the treatment of proximal anterior circulation arterial vasospasm following subarachnoid hemorrhage (SAH). Between 1989 and 1995, 125 vasospastic distal internal carotid artery or proximal middle cerebral artery vessel segments were treated in 52 patients. Methods. Blood flow velocities of the involved vessels were assessed by using transcranial Doppler (TCD) monitoring in relation to the day of treatment with balloon angioplasty or papaverine infusion. Balloon angioplasty and papaverine infusion cohorts were compared based on mean pre- and posttreatment velocity at 24 and 48 hours using the one-tailed, paired-samples t-test. Balloon angioplasty alone was performed in 101 vessel segments (81%) in 39 patients (75%), whereas papaverine infusion alone was used in 24 vessel segments (19%) in 13 patients (25%). Although repeated treatment after balloon angioplasty was needed in only one ...

[1]  L. Wechsler,et al.  Transcranial doppler ultrasonography , 1999 .

[2]  Sean M. Grady,et al.  Predicting outcome in poor-grade patients with subarachnoid hemorrhage: a retrospective review of 159 aggressively managed cases. , 1996, Journal of neurosurgery.

[3]  M. Ohkawa,et al.  Cerebral vasospastic vessels: histologic changes after percutaneous transluminal angioplasty. , 1996, Radiology.

[4]  J. P. Elliott,et al.  Improved outcome after rupture of anterior circulation aneurysms: a retrospective 10-year review of 224 good-grade patients. , 1995, Journal of neurosurgery.

[5]  Sean M. Grady,et al.  Intracranial pressure changes induced during papaverine infusion for treatment of vasospasm. , 1995, Journal of neurosurgery.

[6]  B. Vollrath,et al.  Pharmacological and morphological effects of in vitro transluminal balloon angioplasty on normal and vasospastic canine basilar arteries. , 1995, Journal of neurosurgery.

[7]  M. Ohkawa,et al.  Morphological changes in human cerebral arteries after percutaneous transluminal angioplasty for vasospasm caused by subarachnoid hemorrhage. , 1995, Neurosurgery.

[8]  S. London,et al.  The time course of myosin light-chain phosphorylation in blood-induced vasospasm. , 1995, Neurosurgery.

[9]  H. Winn,et al.  Effect of intra-arterial papaverine on cerebral blood flow in vasospasm after subarachnoid hemorrhage: A study using single-photon emission computed tomography. , 1995, Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association.

[10]  J. Simard,et al.  Intraarterial papaverine infusion for cerebral vasospasm after subarachnoid hemorrhage. , 1995, AJNR. American journal of neuroradiology.

[11]  D. Newell Transcranial Doppler ultrasonography. , 1994, Neurosurgery clinics of North America.

[12]  N. Martin,et al.  Critical care of patients with subarachnoid hemorrhage. , 1994, Neurosurgery clinics of North America.

[13]  J. Dion,et al.  Transient neurologic events associated with intraarterial papaverine infusion for subarachnoid hemorrhage-induced vasospasm. , 1994, AJNR. American journal of neuroradiology.

[14]  J. Dion,et al.  In vitro evaluation of papaverine hydrochloride incompatibilities: a simulation of intraarterial infusion for cerebral vasospasm. , 1994, AJNR. American journal of neuroradiology.

[15]  H. Winn,et al.  Endovascular treatment of vasospasm. , 1994, Neurosurgery clinics of North America.

[16]  J. Mathis,et al.  Transient severe brain stem depression during intraarterial papaverine infusion for cerebral vasospasm. , 1994, AJNR. American journal of neuroradiology.

[17]  H. Winn,et al.  Severe symptomatic vasospasm: the role of immediate postoperative angioplasty. , 1994, Journal of neurosurgery.

[18]  J. P. Elliott,et al.  Anterior circulation aneurysms: improvement in outcome in good-grade patients 1983-1993. , 1994, Clinical neurosurgery.

[19]  H. Winn,et al.  Emergent aneurysm clipping without angiography in the moribund patient with intracerebral hemorrhage: the use of infusion computed tomography scans. , 1993, Neurosurgery.

[20]  E. Raps,et al.  Role of Transcranial Doppler in Neuroradiological Treatment of Intracranial Vasospasm , 1993, Stroke.

[21]  N. Kassell,et al.  Treatment of cerebral vasospasm with intra-arterial papaverine. , 1992, Journal of neurosurgery.

[22]  Y. Yonekawa,et al.  Superselective intra-arterial infusion of papaverine for the treatment of cerebral vasospasm after subarachnoid hemorrhage. , 1992, Journal of neurosurgery.

[23]  K. Leong,et al.  Sustained release of papaverine for the treatment of cerebral vasospasm: in vitro evaluation of release kinetics and biological activity. , 1992, Journal of neurosurgery.

[24]  H. Winn,et al.  Brain SPECT and the effect of cerebral angioplasty in delayed ischemia due to vasospasm. , 1992, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[25]  C. Douville,et al.  Anatomy and freehand examination techniques , 1992 .

[26]  R. R. Smith,et al.  Mechanism of action of balloon angioplasty in cerebral vasospasm. , 1992, Neurosurgery.

[27]  H. Yonas,et al.  Fatal rupture of the intracranial carotid artery during transluminal angioplasty for vasospasm induced by subarachnoid hemorrhage. Case report. , 1991, Journal of neurosurgery.

[28]  K. Hongo,et al.  Pharmacological reversibility of experimental cerebral vasospasm. , 1990, Neurosurgery.

[29]  Sean M. Grady,et al.  Distribution of angiographic vasospasm after subarachnoid hemorrhage: implications for diagnosis by transcranial Doppler ultrasonography. , 1990, Neurosurgery.

[30]  H. Adams,et al.  The International Cooperative Study on the Timing of Aneurysm Surgery. Part 1: Overall management results. , 1990, Journal of neurosurgery.

[31]  J. Soucy,et al.  Evaluation of vasospasm secondary to subarachnoid hemorrhage with technetium-99m-hexamethyl-propyleneamine oxime (HM-PAO) tomoscintigraphy. , 1990, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[32]  D. Newell,et al.  Transluminal angioplasty for treatment of vasospasm. , 1990, Neurosurgery clinics of North America.

[33]  H. Winn,et al.  Transcranial Doppler in cerebral vasospasm. , 1990, Neurosurgery clinics of North America.

[34]  H. Winn,et al.  Angioplasty for the treatment of symptomatic vasospasm following subarachnoid hemorrhage. , 1989, Journal of neurosurgery.

[35]  R. Higashida,et al.  Transluminal angioplasty for treatment of intracranial arterial vasospasm. , 1989, Journal of neurosurgery.

[36]  R. Higashida,et al.  Transluminal angioplasty of intracerebral vessels for cerebral arterial spasm: reversal of neurological deficits after delayed treatment. , 1989, Neurosurgery.

[37]  R G Dacey,et al.  CT infusion scanning for the detection of cerebral aneurysms. , 1989, Journal of neurosurgery.

[38]  G. Murray,et al.  Effect of oral nimodipine on cerebral infarction and outcome after subarachnoid haemorrhage: British aneurysm nimodipine trial. , 1989, BMJ.

[39]  David Gur,et al.  Determination of irreversible ischemia by xenon-enhanced computed tomographic monitoring of cerebral blood flow in patients with symptomatic vasospasm. , 1989, Neurosurgery.

[40]  R. A. Solomon,et al.  Early aneurysm surgery and prophylactic hypervolemic hypertensive therapy for the treatment of aneurysmal subarachnoid hemorrhage. , 1988, Neurosurgery.

[41]  A. Harders,et al.  Time course of blood velocity changes related to vasospasm in the circle of Willis measured by transcranial Doppler ultrasound. , 1987, Journal of neurosurgery.

[42]  R. Aaslid,et al.  Evaluation of cerebrovascular spasm with transcranial Doppler ultrasound. , 1984, Journal of neurosurgery.

[43]  R. Aaslid,et al.  Noninvasive transcranial Doppler ultrasound recording of flow velocity in basal cerebral arteries. , 1982, Journal of neurosurgery.

[44]  W. Lougheed,et al.  Observations on the effects of intrathecal papaverine in experimental vasospasm. , 1973, Journal of neurosurgery.

[45]  N. Zervas,et al.  Papaverine Hydrochloride and Experimental Hemorrhagic Cerebral Arterial Spasm , 1972, Stroke.