Controversies in the endovascular management of cerebral vasospasm after intracranial aneurysm rupture and future directions for therapeutic approaches

Ricardo J. Komotar, Brad E. Zacharia, Marc L. Otten, J. Mocco, Sean D. Lavine

Research output: Contribution to journalArticle

31 Scopus citations

Abstract

CEREBRAL VASOSPASM IS one of the leading causes of morbidity and mortality after aneurysmal subarachnoid hemorrhage. Despite maximal medical therapy, however, up to 15% of patients surviving the ictus of subarachnoid hemorrhage experience stroke or death from vasospasm. For those cases of vasospasm that are refractory to medical treatment, endovascular techniques are frequently used, including balloon angioplasty with or without intra-arterial infusion of vasodilators, combined endovascular modalities, and aortic balloon devices. In this article, we review each of these therapies and their expanding role in the management of this condition. Moving forward, rigorous prospective outcome assessments after endovascular treatment of cerebral vasospasm are necessary to clearly delineate the efficacy and indications for these techniques.

Original languageEnglish (US)
Pages (from-to)897-905
Number of pages9
JournalNeurosurgery
Volume62
Issue number4
DOIs
StatePublished - Apr 1 2008
Externally publishedYes

Keywords

  • Aneurysm
  • Angioplasty
  • Endovascular
  • Subarachnoid hemorrhage
  • Vasospasm

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery

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