Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
BMC Neurology
Published in: BMC Neurology 1/2020

Open Access 01-12-2020 | Nimodipine | Research article

Angioplasty with the scepter C dual lumen balloon catheter and postprocedural result evaluation in patients with subarachnoid hemorrhage related vasospasms

Authors: Ioannis Tsogkas, Vesna Malinova, Katharina Schregel, Dorothee Mielke, Daniel Behme, Veit Rohde, Michael Knauth, Marios-Nikos Psychogios

Published in: BMC Neurology | Issue 1/2020

Login to get access

Abstract

Background

Delayed cerebral ischemia is one of the leading causes of death and disability in patients with subarachnoid hemorrhage (SAH). Transluminal balloon angioplasty (TBA) is a therapeutic option for vasospasms affecting proximal intracranial arteries.

Methods

Aim of this study was to report our experience using the Scepter C balloon catheter in the treatment of cerebral vasospasms due to SAH and evaluate the postprocedural result with the iFlow tool. We reviewed cases of patients treated at our hospital from 2014 to 2018. Patients were screened with transcranial doppler sonography (TCD) and multimodal computed tomography. In case of significant vasospasms, patients were transferred to the angiography suite and treated. We used the iFlow tool to quantify and evaluate the angiographic results by measuring and comparing peak density values on angiograms before and after the mechanical dilation.

Results

The use of the Scepter C balloon catheter was feasible in all cases. Vasospasms of the anterior cerebral artery were treated in ten cases. We didn’t observe complications or vasospasm recurrences of the treated arteries. The temporal difference between distal vessels and the proximal reference vessel was significantly reduced from a mean of 53%, prior to dilatation, to 26% after the treatment. The difference between pre-dilatation and post-dilatation values was statistically significant for the anterior circulation at the proximal as well as at the distal vessels.

Conclusions

We successfully treated endovascularly patients suffering from cerebral vasospasms refractory to medical treatment using the Scepter C balloon catheter. We didn’t observe any complications. The therapeutic effect could be easily and reliably assessed with the iFlow tool.
Literature
1.
Findlay JM, Nisar J, Darsaut T. Cerebral vasospasm: a review. Can J Neurol Sci. 2016;43(1):15–32.CrossRef
2.
Dorsch NW, King MT. A review of cerebral vasospasm in aneurysmal subarachnoid haemorrhage part I: incidence and effects. J Clin Neurosci. 1994;1(1):19–26.CrossRef
3.
Murayama Y, Malisch T, Guglielmi G, Mawad ME, Vinuela F, Duckwiler GR, et al. Incidence of cerebral vasospasm after endovascular treatment of acutely ruptured aneurysms: report on 69 cases. J Neurosurg. 1997;87(6):830–5.CrossRef
4.
Charpentier C, Audibert G, Guillemin F, Civit T, Ducrocq X, Bracard S, et al. Multivariate analysis of predictors of cerebral vasospasm occurrence after aneurysmal subarachnoid hemorrhage. Stroke. 1999;30(7):1402–8.CrossRef
5.
Allen GS, Ahn HS, Preziosi TJ, Battye R, Boone SC, Chou SN, et al. Cerebral arterial spasm--a controlled trial of nimodipine in patients with subarachnoid hemorrhage. N Engl J Med. 1983;308(11):619–24.CrossRef
6.
Barker FG 2nd, Ogilvy CS. Efficacy of prophylactic nimodipine for delayed ischemic deficit after subarachnoid hemorrhage: a metaanalysis. J Neurosurg. 1996;84(3):405–14.CrossRef
7.
Mee E, Dorrance D, Lowe D, Neil-Dwyer G. Controlled study of nimodipine in aneurysm patients treated early after subarachnoid hemorrhage. Neurosurgery. 1988;22(3):484–91.CrossRef
8.
Ohman J, Heiskanen O. Effect of nimodipine on the outcome of patients after aneurysmal subarachnoid hemorrhage and surgery. J Neurosurg. 1988;69(5):683–6.CrossRef
9.
Petruk KC, West M, Mohr G, Weir BK, Benoit BG, Gentili F, et al. Nimodipine treatment in poor-grade aneurysm patients. Results of a multicenter double-blind placebo-controlled trial. J Neurosurg. 1988;68(4):505–17.CrossRef
10.
Philippon J, Grob R, Dagreou F, Guggiari M, Rivierez M, Viars P. Prevention of vasospasm in subarachnoid haemorrhage. A controlled study with nimodipine. Acta Neurochir. 1986;82(3–4):110–4.CrossRef
11.
Pickard JD, Murray GD, Illingworth R, Shaw MD, Teasdale GM, Foy PM, et al. Effect of oral nimodipine on cerebral infarction and outcome after subarachnoid haemorrhage: British aneurysm nimodipine trial. BMJ. 1989;298(6674):636–42.CrossRef
12.
Hollingworth M, Chen PR, Goddard AJ, Coulthard A, Soderman M, Bulsara KR. Results of an international survey on the investigation and endovascular Management of Cerebral Vasospasm and Delayed Cerebral Ischemia. World Neurosurg. 2015;83(6):1120–6 e1121.CrossRef
13.
Eskridge JM, Newell DW, Winn HR. Endovascular treatment of vasospasm. Neurosurg Clin N Am. 1994;5(3):437–47.CrossRef
14.
Coyne TJ, Montanera WJ, Macdonald RL, Wallace MC. Percutaneous transluminal angioplasty for cerebral vasospasm after subarachnoid hemorrhage. Can J Surg. 1994;37(5):391–6.PubMed
15.
Bejjani GK, WOF B, Olan WJ, Sekhar LN. The efficacy and safety of angioplasty for cerebral vasospasm after subarachnoid hemorrhage. Neurosurgery. 1998;42(5):979–86 discussion 986-977.CrossRef
16.
Fujii Y, Takahashi A, Yoshimoto T. Effect of balloon angioplasty on high grade symptomatic vasospasm after subarachnoid hemorrhage. Neurosurg Rev. 1995;18(1):7–13.CrossRef
17.
Teitelbaum GP, Larsen DW, Zelman V, Lysachev AG, Likhterman LB. A tribute to Dr. Fedor a. Serbinenko, founder of endovascular neurosurgery. Neurosurgery. 2000;46(2):462–9 discussion 469-470.CrossRef
18.
Gonzalez NR, Boscardin WJ, Glenn T, Vinuela F, Martin NA. Vasospasm probability index: a combination of transcranial doppler velocities, cerebral blood flow, and clinical risk factors to predict cerebral vasospasm after aneurysmal subarachnoid hemorrhage. J Neurosurg. 2007;107(6):1101–12.CrossRef
19.
Yamamoto K, Nakai G, Azuma H, Narumi Y. Novel software-assisted hemodynamic evaluation of pelvic flow during Chemoperfusion of pelvic arteries for bladder cancer: double- versus single-balloon technique. Cardiovasc Intervent Radiol. 2016;39(6):824–30.CrossRef
20.
Kassell NF, Torner JC, Haley EC Jr, Jane JA, Adams HP, Kongable GL. The international cooperative study on the timing of aneurysm surgery. Part 1: overall management results. J Neurosurg. 1990;73(1):18–36.CrossRef
21.
Broderick JP, Brott TG, Duldner JE, Tomsick T, Leach A. Initial and recurrent bleeding are the major causes of death following subarachnoid hemorrhage. Stroke. 1994;25(7):1342–7.CrossRef
22.
Proust F, Hannequin D, Langlois O, Freger P, Creissard P. Causes of morbidity and mortality after ruptured aneurysm surgery in a series of 230 patients. The importance of control angiography. Stroke. 1995;26(9):1553–7.CrossRef
23.
Lovelock CE, Rinkel GJ, Rothwell PM. Time trends in outcome of subarachnoid hemorrhage: population-based study and systematic review. Neurology. 2010;74(19):1494–501.CrossRef
24.
Zwienenberg-Lee M, Hartman J, Rudisill N, Muizelaar JP. Endovascular management of cerebral vasospasm. Neurosurgery. 2006;59(5 Suppl 3):S139–47 discussion S133–113.PubMed
25.
Jestaedt L, Pham M, Bartsch AJ, Kunze E, Roosen K, Solymosi L, et al. The impact of balloon angioplasty on the evolution of vasospasm-related infarction after aneurysmal subarachnoid hemorrhage. Neurosurgery. 2008;62(3):610–7 discussion 610-617.CrossRef
26.
Hoh BL, Ogilvy CS. Endovascular treatment of cerebral vasospasm: transluminal balloon angioplasty, intra-arterial papaverine, and intra-arterial nicardipine. Neurosurg Clin N Am. 2005;16(3):501–16 vi.CrossRef
27.
Santillan A, Knopman J, Zink W, Patsalides A, Gobin YP. Transluminal balloon angioplasty for symptomatic distal vasospasm refractory to medical therapy in patients with aneurysmal subarachnoid hemorrhage. Neurosurgery. 2011;69(1):95–101 discussion 102.CrossRef
28.
Tekle WG, Chaudry SA, Hassan AE, Qaiser H, Grigoryan M, Rodriguez GJ, et al. High risk of new episode of symptomatic vasospasm in unaffected arteries in subarachnoid hemorrhage patients receiving targeted endovascular treatment for symptomatic focal vasospasm. Neurocrit Care. 2014;20(3):399–405.CrossRef
29.
John S, Spiotta AM, Turner RM, Chaudry MI, Turk AS, Hui F. Initial experience with the coaxial dual-lumen scepter C balloon catheter for endovascular management of cerebral vasospasm from subarachnoid hemorrhage. J Neurointerventional Surg. 2014;6(2):125–8.CrossRef
30.
Connolly ES Jr, Rabinstein AA, Carhuapoma JR, Derdeyn CP, Dion J, Higashida RT, et al. Guidelines for the management of aneurysmal subarachnoid hemorrhage: a guideline for healthcare professionals from the American Heart Association/american Stroke Association. Stroke. 2012;43(6):1711–37.CrossRef
Metadata
Title
Angioplasty with the scepter C dual lumen balloon catheter and postprocedural result evaluation in patients with subarachnoid hemorrhage related vasospasms
Authors
Ioannis Tsogkas
Vesna Malinova
Katharina Schregel
Dorothee Mielke
Daniel Behme
Veit Rohde
Michael Knauth
Marios-Nikos Psychogios
Publication date
01-12-2020
Publisher
BioMed Central
Published in
BMC Neurology / Issue 1/2020
Electronic ISSN: 1471-2377
DOI
https://doi.org/10.1186/s12883-020-01792-3

Other articles of this Issue 1/2020

BMC Neurology 1/2020 Go to the issue

Case report

Unruptured aneurysmal clipping complicated by delayed and refractory vasospasm: case report

Research article

Spinal cerebrospinal fluid leak in the context of pars interarticularis fracture

Case report

Myotonic dystrophy type 1 accompanied with normal pressure hydrocephalus: a case report and literature review

Research article

A new approach to characterize postural deficits in chemotherapy-induced peripheral neuropathy and to analyze postural adaptions after an exercise intervention

Study protocol

A longitudinal study of the post-stroke immune response and cognitive functioning: the StrokeCog study protocol

Research article

A new nomogram for individualized prediction of the probability of hemorrhagic transformation after intravenous thrombolysis for ischemic stroke patients