ArticleBrain & spine2024
Endovascular therapy for cerebral vasospasm after aneurysmal subarachnoid hemorrhage: Single-center experience in a high-volume neurovascular unit.
Article in Brain & spine, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
1 citing paper in PubMed, 1 synthesis or guideline pooled it.
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Authors and funding
15 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Introduction: Despite targeted standard therapy, aneurysmal subarachnoid hemorrhage (aSAH) frequently leads to cerebral vasospasms (CVS) of large cerebral arteries, reduced oxygen supply of brain tissue, known as delayed cerebral ischemia (DCI), subsequent development of manifest cerebral infarction and poor neurological outcome. Research question: The primary aim was to evaluate the efficacy of endovascular spasmolysis (eSL) as a rescue therapy for delayed ischemic neurological deficits (DIND) occurring despite maximum conservative treatment, with the potential benefit of preventing permanent ischemic deficits, and thus, improving overall neurological outcomes. Material and methods: In our retrospective, monocentric study, we included 310 patients developing CVS during hospitalization and evaluated their clinical and radiographic outcomes. Severe vasospasm was defined by a mean velocity of >200 cm/s in transcranial Doppler ultrasound and/or occurrence of new neurological deficits, and/or decrease of at least 2 points on the Glasgow Coma Scale (GCS), respectively. Results: 92 patients (29.7%) underwent eSL due to persistent symptoms despite conservative therapy. Among endovascularly treated patients, 86% (n = 79) improved angiographically, 71% (n = 44) of 62 patients who underwent eSL due to symptomatic deterioration improved clinically. Clinical worsening due to progressive CVS occurred in 18% of cases (n = 11). Periprocedural complications were observed in 4% (n = 4). Discussion and conclusion: eSL emerges as a safe and effective therapy for individuals experiencing DIND triggered by large-artery vasospasm following aSAH. The implementation of a standardized, multi-step process for detection and management, coupled with criteria for endovascular interventions, proves to be an efficient preventative approach to enhance neurological outcomes after aSAH.
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