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同轴双通道 Scepter C 球囊导管在颅内出血性蛛网膜下腔出血所致脑血管痉挛血管内治疗中的初步经验。

Initial experience with the coaxial dual-lumen Scepter C balloon catheter for endovascular management of cerebral vasospasm from subarachnoid hemorrhage.

机构信息

Cerebrovascular Center, Neurological Institute, Cleveland Clinic, Cleveland, Ohio, USA.

出版信息

J Neurointerv Surg. 2014 Mar;6(2):125-8. doi: 10.1136/neurintsurg-2012-010572. Epub 2013 Jan 31.

Abstract

BACKGROUND

Post-hemorrhagic cerebral vasospasm accounts for significant morbidity and mortality in patients with subarachnoid hemorrhage (SAH). Intra-arterial therapies including vasodilator administration and/or balloon angioplasty are used when medical management fails. The Scepter C is a newer dual coaxial lumen temporary occlusion balloon catheter used for the treatment of post-hemorrhagic cerebral vasospasm.

OBJECTIVE

To report our early experience with the use of Scepter C for the treatment of post-hemorrhagic cerebral vasospasm.

METHODS

We reviewed cases from two institutions where the Scepter C balloon catheter was used for the treatment of cerebral vasospasm related to SAH.

RESULTS

Seven patients were identified who underwent endovascular treatment with the Scepter C balloon catheter for treatment of SAH-related cerebral vasospasm. All patients had cerebral vasospasm that was refractory to medical management and it was technically feasible to use the catheter for this indication. Compared with larger double-lumen catheters, the Scepter C catheter was more trackable given the presence of a more steerable microwire. There were no complications or large vessel vasospasm recurrence after the procedure requiring repeat intra-arterial therapy.

CONCLUSIONS

Endovascular treatment for post-hemorrhagic cerebral vasospasm is used when medical management fails or because of complications of medical therapies. With continuing advancements in the development of endovascular devices and techniques, more options are available for the management of cerebral vasospasm. Our initial experience with the dual coaxial lumen Scepter C occlusion balloon catheter demonstrates its feasibility in the treatment of cerebral vasospasm.

摘要

背景

蛛网膜下腔出血(SAH)后发生的脑血管痉挛会导致患者出现较高的发病率和死亡率。当药物治疗失败时,会采用包括血管扩张剂给药和/或球囊血管成形术在内的动脉内治疗。Scepter C 是一种新型的双同轴腔临时闭塞球囊导管,用于治疗出血后脑血管痉挛。

目的

报告我们使用 Scepter C 治疗出血后脑血管痉挛的早期经验。

方法

我们回顾了两家机构的病例,这些病例中使用了 Scepter C 球囊导管治疗与 SAH 相关的脑血管痉挛。

结果

确定了 7 例患者接受了 Scepter C 球囊导管的血管内治疗,以治疗与 SAH 相关的脑血管痉挛。所有患者的脑血管痉挛均对药物治疗无反应,且技术上可行使用导管进行该适应证的治疗。与较大的双腔导管相比,由于存在更可操控的微导丝,Scepter C 导管更具可追踪性。在该程序之后,没有并发症或大血管血管痉挛复发需要再次进行动脉内治疗。

结论

当药物治疗失败或因药物治疗的并发症而需要时,会采用血管内治疗治疗出血后脑血管痉挛。随着血管内设备和技术的不断发展,为脑血管痉挛的治疗提供了更多的选择。我们使用双同轴腔 Scepter C 闭塞球囊导管的初步经验证明了其在治疗脑血管痉挛方面的可行性。

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