Efficacy of percutaneous transluminal angioplasty and intra-arterial infusion of fasudil hydrochloride on cerebral vasospasm following subarachnoid hemorrhage

Akio Soeda, Kenichi Murao, Koji Iihara, Toshio Higashi, Shuji Kogure, Jun C. Takahashi, Katsuhiko Hayashi, Hajime Ohta, Tomoaki Nagamine, Toshihiro Ishibashi, Ryogo Anei, Ayumi Taniguchi, Hitoshi Fukuda, Naoki Fukui, Izumi Nagata

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Abstract

In this study, the efficacy of percutaneous transluminal angioplasty (PTA) and intra-arterial infusion of fasudil hydrochloride (FH) on cerebral vasospasm after subarachnoid hemorrhage were reviewed. Twenty-two arterial territories in 15 patients were treated according to the following strategy. Vasospasm located on the proximal intracranial vessels (ICA and M1) was treated with PTA and intra-arterial infusion of FH was selected for vasospasm at more distal locations. Angiographic improvement of vasospasm was demonstrated in 19 territories (86%) and 9 of 11 symptomatic patients (82%) showed neurological improvement after the procedure. Angiographic vasoconstriction recurred in 7 territories (43%), and neurological deficits recurred in 3 patients (33%). Recurrence of vasoconstriction was seen only after intra-arterial infusion of FH. After treating the 22 vascular territories, 16 (73%) were prevented from large ischemic change on post-procedural computed tomographies. There were no episodes of systemic hypotension and no severe adverse effects were encountered. We concluded that the combined use of PTA and intra-arterial infusion of FH was useful for cerebral vasospasm following subarachnoid hemorrhage.

Original languageEnglish
Pages (from-to)672-679
Number of pages8
JournalJapanese Journal of Neurosurgery
Volume11
Issue number10
DOIs
Publication statusPublished - Oct 1 2002
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Surgery
  • Clinical Neurology

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