Journal of neurointerventional surgery
-
Review Case Reports
Management of vasospasm in ruptured unsecured intracranial vascular lesions: review of 10 cases.
Risks associated with endovascular management remain unaddressed for post-hemorrhagic cerebral vasospasm (PHCV) caused by pathologies that cannot be secured or identified before vasospasm treatment. This retrospective study reviews our 10 year experience in the difficult scenario of subarachnoid hemorrhage (SAH) with vasospasm, including intra-arterial vasodilators or percutaneous transluminal angioplasty (PTA) to vessels feeding a ruptured unsecured lesion. ⋯ Endovascular treatment appeared safe for PHCV for vessels not supplying the index arterial lesion and for angiographically negative SAH. Vasodilators were safe for vessels harboring partially secured, ruptured lesions (eg, incompletely coiled aneurysms, stented dissections). Following two major complications, the safety of administering vasodilators or performing PTA to vessels supplying completely unsecured vascular lesions remains inconclusive and should be used cautiously.
-
Review Case Reports
Balloon-assisted guide catheter positioning to overcome extreme cervical carotid tortuosity: technique and case experience.
We describe a method by which to efficiently and atraumatically achieve distal positioning of a flexible guiding catheter beyond extreme cervical tortuosity using a hypercompliant temporary occlusion balloon. ⋯ Hypercompliant balloon catheters can be reliably used to facilitate safe and rapid distal positioning of flexible guiding catheters beyond severe cervical tortuosity.