Jeremy J Heit1, Omar Choudhri2, Michael P Marks3, Robert L Dodd3, Huy M Do3. 1. Interventional Neuroradiology Division, Department of Radiology, Stanford University Hospital, Stanford, California, USA. 2. Department of Neurosurgery, Stanford University Hospital, Stanford, California, USA. 3. Interventional Neuroradiology Division, Department of Radiology, Stanford University Hospital, Stanford, California, USA Department of Neurosurgery, Stanford University Hospital, Stanford, California, USA.
Abstract
BACKGROUND: Cerebral vasospasm following subarachnoid hemorrhage (SAH) results in significant morbidity and mortality. Intra-arterial administration of calcium channel blockers or intracranial angioplasty may be performed when non-invasive medical management fails to prevent neurologic deterioration. Technical improvements in balloon catheters are expected to improve the success and safety of cerebral angioplasty. OBJECTIVE: To describe our initial experience with the new Scepter XC balloon catheter in cerebral vasospasm treatment following SAH. DESIGN: All patients who underwent cerebral angioplasty using the Scepter XC balloon for the treatment of medically refractory cerebral vasospasm after SAH were identified. Patient demographic information, procedural details, and outcome were obtained from electronic medical records. RESULTS: Five consecutive patients undergoing vasospasm treatment with cerebral angioplasty using the Scepter XC were identified. All treated patients had medically refractory vasospasm that was moderate or severe. Angioplasty of the supraclinoid internal carotid artery, the A1 and A2 segments of the anterior cerebral artery, the M1 and M2 segments of the middle cerebral artery, the V4 segment of the vertebral artery, and the basilar artery was performed. All angioplasty procedures were technically successful, and the degree of vasospasm improved significantly following angioplasty. There were no complications related to the cerebral angioplasty procedures. CONCLUSIONS: The Scepter XC balloon catheter is safe and effective in the treatment of cerebral vasospasm following SAH. The excellent trackability and stability of the balloon catheter and the extra compliant design of the balloon represent technical advancements in the endovascular armamentarium in the treatment of cerebral vasospasm. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
BACKGROUND:Cerebral vasospasm following subarachnoid hemorrhage (SAH) results in significant morbidity and mortality. Intra-arterial administration of calcium channel blockers or intracranial angioplasty may be performed when non-invasive medical management fails to prevent neurologic deterioration. Technical improvements in balloon catheters are expected to improve the success and safety of cerebral angioplasty. OBJECTIVE: To describe our initial experience with the new Scepter XC balloon catheter in cerebral vasospasm treatment following SAH. DESIGN: All patients who underwent cerebral angioplasty using the Scepter XC balloon for the treatment of medically refractory cerebral vasospasm after SAH were identified. Patient demographic information, procedural details, and outcome were obtained from electronic medical records. RESULTS: Five consecutive patients undergoing vasospasm treatment with cerebral angioplasty using the Scepter XC were identified. All treated patients had medically refractory vasospasm that was moderate or severe. Angioplasty of the supraclinoid internal carotid artery, the A1 and A2 segments of the anterior cerebral artery, the M1 and M2 segments of the middle cerebral artery, the V4 segment of the vertebral artery, and the basilar artery was performed. All angioplasty procedures were technically successful, and the degree of vasospasm improved significantly following angioplasty. There were no complications related to the cerebral angioplasty procedures. CONCLUSIONS: The Scepter XC balloon catheter is safe and effective in the treatment of cerebral vasospasm following SAH. The excellent trackability and stability of the balloon catheter and the extra compliant design of the balloon represent technical advancements in the endovascular armamentarium in the treatment of cerebral vasospasm. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
Authors: Alexander Neumann; Jan Küchler; Claudia Ditz; Kara Krajewski; Jan Leppert; Peter Schramm; Hannes Schacht Journal: Stroke Vasc Neurol Date: 2020-07-23
Authors: Bradley A Gross; Daniel A Tonetti; Gregory M Weiner; David M Panczykowski; William J Ares; Cynthia L Kenmuir; Ashutosh P Jadhav; Tudor G Jovin; Brian T Jankowitz Journal: Interv Neurol Date: 2017-06-21