Korean Journal of Radiology

The Korean Society of Radiology (대한영상의학회)
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Simultaneous Endovascular Treatment of Ruptured Cerebral Aneurysms and Vasospasm

  • Cho, Young Dae (Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine) ;
  • Han, Moon Hee (Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine) ;
  • Ahn, Jun Hyong (Department of Neurosurgery, Hallym University Sacred Heart Hospital, Hallym University College of Medicine) ;
  • Jung, Seung Chai (Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Kim, Chang Hun (Department of Neurology, Stroke Center, Myongji Hospital) ;
  • Kang, Hyun-Seung (Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine) ;
  • Kim, Jeong Eun (Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine) ;
  • Lim, Jeong Wook (Department of Neurosurgery, Sun Hospital)
  • Received : 2014.01.29
  • Accepted : 2014.09.20
  • Published : 2015.02.01
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Abstract

Objective: The management of patients with ruptured cerebral aneurysms and severe vasospasm is subject to considerable controversy. We intended to describe herein an endovascular technique for the simultaneous treatment of aneurysms and vasospasm. Materials and Methods: A series of 11 patients undergoing simultaneous endovascular treatment of ruptured aneurysms and vasospasm were reviewed. After placement of a guiding catheter within the proximal internal carotid artery for coil embolization, an infusion line of nimodipine was wired to one hub, and of a microcatheter was advanced through another hub (to select and deliver detachable coils). Nimodipine was then infused continuously during the coil embolization. Results: This technique was applied to 11 ruptured aneurysms accompanied by vasospasm (anterior communicating artery, 6 patients; internal carotid artery, 2 patients; posterior communicating and middle cerebral arteries, 1 patient each). Aneurysmal occlusion by coils and nimodipine-induced angioplasty were simultaneously achieved, resulting in excellent outcomes for all patients, and there were no procedure-related complications. Eight patients required repeated nimodipine infusions. Conclusion: Our small series of patients suggests that the simultaneous endovascular management of ruptured cerebral aneurysms and vasospasm is a viable approach in patients presenting with subarachnoid hemorrhage and severe vasospasm.

Keywords

References

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