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Titolo:
SEVERE SYMPTOMATIC VASOSPASM - THE ROLE OF IMMEDIATE POSTOPERATIVE ANGIOPLASTY
Autore:
LEROUX PD; NEWELL DW; ESKRIDGE J; MAYBERG MR; WINN HR;
Indirizzi:
UNIV WASHINGTON,DEPT NEUROSURG,RI-20 SEATTLE WA 98195 UNIV WASHINGTON,DEPT RADIOL SEATTLE WA 98195 UNIV WASHINGTON,HARBORVIEW MED CTR SEATTLE WA 98104
Titolo Testata:
Journal of neurosurgery
fascicolo: 2, volume: 80, anno: 1994,
pagine: 224 - 229
SICI:
0022-3085(1994)80:2<224:SSV-TR>2.0.ZU;2-F
Fonte:
ISI
Lingua:
ENG
Soggetto:
CEREBRAL BLOOD-FLOW; ANEURYSMAL SUBARACHNOID HEMORRHAGE; INTRACRANIAL ARTERIAL VASOSPASM; SURGERY; THERAPY; UPDATE;
Keywords:
ANEURYSM; ANGIOPLASTY; INTERVENTIONAL RADIOLOGY; VASOSPASM; SUBARACHNOID HEMORRHAGE;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Science Citation Index Expanded
Citazioni:
39
Recensione:
Indirizzi per estratti:
Citazione:
P.D. Leroux et al., "SEVERE SYMPTOMATIC VASOSPASM - THE ROLE OF IMMEDIATE POSTOPERATIVE ANGIOPLASTY", Journal of neurosurgery, 80(2), 1994, pp. 224-229

Abstract

The clinical success of angioplasty for symptomatic vasospasm following subarachnoid hemorrhage (SAH) depends on early intervention and canbest be achieved after the aneurysm is occluded. However, patients presenting with unsecured ruptured aneurysms and established clinical vasospasm offer a dilemma for the surgeon. The authors describe the cases of five such patients who underwent acute clipping of aneurysms followed by immediate postoperative angioplasty between 1988 and 1992. Allwere referred at least 5 days after SAH. Severe vasospasm compatible with the clinical presentation was confirmed by angiography. The patients met the department's criteria for angioplasty but, because of unclipped aneurysms, were first taken to the operating room for a craniotomy and aneurysm obliteration. Angiography was repeated immediately after surgery. Arterial narrowing had progressed during surgery in two patients. In all patients, postoperative mechanical dilatation was achieved with the use of a silicone microballoon. Following angioplasty, transcranial Doppler ultrasound flow velocities and single-photon emission computerized tomography evaluation indicated improved cerebral perfusion compared to preoperative determinations. Four patients improved clinically and made a good recovery. In this subgroup of patients presenting with proven symptomatic vasospasm and an unclipped but rupturedaneurysm, urgent surgical obliteration of the aneurysm followed by immediate post-operative angioplasty may be a safe and reasonable means to improve outcome.

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Documento generato il 25/09/20 alle ore 10:04:33