[Endovascular Treatment of Delayed Cerebral Vasospasms]

No Shinkei Geka. 2024 Sep;52(5):1023-1030. doi: 10.11477/mf.1436205012.
[Article in Japanese]

Abstract

Delayed cerebral vasospasm is a major complication following subarachnoid hemorrhage and a primary cause of delayed cerebral ischemia. While various preventive treatments exist, some patients still develop severe vasospasm, highlighting the need for better rescue therapies. This article explores endovascular treatment as a rescue option for vasospasm, focusing on the clinical characteristics and roles of intra-arterial vasodilator injection therapy and percutaneous transluminal angioplasty(PTA). Despite a lack of strong evidence from large clinical trials, advancements in endovascular technology have positioned both intra-arterial vasodilator injection therapy and PTA as promising and safe rescue options for severe vasospasm. Careful selection of the appropriate approach is crucial for achieving optimal clinical outcomes, considering the unique characteristics, advantages, and limitations of each method. Further clinical trials are necessary to definitively confirm this hypothesis.

Publication types

  • Review
  • English Abstract

MeSH terms

  • Endovascular Procedures* / methods
  • Humans
  • Subarachnoid Hemorrhage* / complications
  • Subarachnoid Hemorrhage* / surgery
  • Vasodilator Agents / administration & dosage
  • Vasodilator Agents / therapeutic use
  • Vasospasm, Intracranial* / diagnostic imaging
  • Vasospasm, Intracranial* / etiology
  • Vasospasm, Intracranial* / therapy

Substances

  • Vasodilator Agents