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Titolo:
INTRAARTERIAL PAPAVERINE INFUSION FOR CEREBRAL VASOSPASM AFTER SUBARACHNOID HEMORRHAGE
Autore:
CLOUSTON JE; NUMAGUCHI Y; ZOARSKI GH; ALDRICH EF; SIMARD JM; ZITNAY KM;
Indirizzi:
UNIV ROCHESTER,MED CTR,601 ELMWOOD AVE,BOX 648 ROCHESTER NY 14642 UNIV MARYLAND,MED SYST,DEPT RADIOL BALTIMORE MD 21201 UNIV MARYLAND,MED SYST,DIV NEUROL SURG BALTIMORE MD 21201
Titolo Testata:
American journal of neuroradiology
fascicolo: 1, volume: 16, anno: 1995,
pagine: 27 - 38
SICI:
0195-6108(1995)16:1<27:IPIFCV>2.0.ZU;2-R
Fonte:
ISI
Lingua:
ENG
Soggetto:
INTRACRANIAL ARTERIAL VASOSPASM; TRANSLUMINAL ANGIOPLASTY; VESSELS; NIFEDIPINE; MANAGEMENT; DILATATION; WALL;
Keywords:
VASOSPASM; SUBARACHNOID SPACE, HEMORRHAGE; DRUGS, INTRAARTERIAL INJECTION; INTERVENTIONAL NEURORADIOLOGY;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Science Citation Index Expanded
Citazioni:
31
Recensione:
Indirizzi per estratti:
Citazione:
J.E. Clouston et al., "INTRAARTERIAL PAPAVERINE INFUSION FOR CEREBRAL VASOSPASM AFTER SUBARACHNOID HEMORRHAGE", American journal of neuroradiology, 16(1), 1995, pp. 27-38

Abstract

PURPOSE: To evaluate the techniques and efficacy of intracranial intraarterial papaverine infusion for symptomatic vasospasm after subarachnoid hemorrhage caused by aneurysm rupture. METHODS: Papaverine was infused on 19 occasions in 14 patients, 6 hours to 2 days after spasm became apparent clinically. Sixty vascular territories were treated. Infusion was made into the supraclinoid internal carotid artery 20 times,cavernous internal carotid artery once, selective A1 anterior cerebral artery 8 times, M1 middle cerebral artery 7 times, and basilar artery 3 times. Papaverine doses ranged from 150 to 600 mg and exceeded 400mg on 8 occasions. RESULTS: Angiographic improvement occurred in 18 (95%) of the 19 treatment sessions: results were excellent in 3 sessions, moderate in 8, and mild in 7. The best angiographic results often were obtained with superselective infusion, although angiographic results did not always correlate with clinical response. Seven (50%) of the14 treated patients showed dramatic acute clinical improvement within24 hours of papaverine therapy, and there was no clinical evidence ofrecurrent vasospasm in these patients. Recurrence of angiographic vasoconstriction was demonstrated in three patients; one showed marked clinical improvement after a second treatment. There were no episodes ofsystemic hypotension in any of the cases. Monocular blindness developed in one patient because of papaverine infusion near the ophthalmic artery. CONCLUSIONS: Papaverine was effective in dilating narrowed arteries in most patients with symptomatic vasospasm caused by subarachnoid hemorrhage. This series showed encouraging clinical results with no recurrence of neurologic deterioration in those patients who respondedwell to papaverine. Superselective infusion appears to be indicated in some cases for adequate papaverine delivery.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 21/09/20 alle ore 06:39:00