Department of Neuroradiology, University Medical Center Goettingen, Robert-Koch-Str. 40, 37075, Gottingen, Germany.
Department of Neuroradiology, Clinic of Radiology & Nuclear Medicine, University Hospital Basel, Petersgraben 4, 4031, Basel, Basel, Switzerland.
BMC Neurol. 2020 Jun 29;20(1):260. doi: 10.1186/s12883-020-01792-3.
Delayed cerebral ischemia is one of the leading causes of death and disability in patients with subarachnoid hemorrhage (SAH). Transluminal balloon angioplasty (TBA) is a therapeutic option for vasospasms affecting proximal intracranial arteries.
Aim of this study was to report our experience using the Scepter C balloon catheter in the treatment of cerebral vasospasms due to SAH and evaluate the postprocedural result with the iFlow tool. We reviewed cases of patients treated at our hospital from 2014 to 2018. Patients were screened with transcranial doppler sonography (TCD) and multimodal computed tomography. In case of significant vasospasms, patients were transferred to the angiography suite and treated. We used the iFlow tool to quantify and evaluate the angiographic results by measuring and comparing peak density values on angiograms before and after the mechanical dilation.
The use of the Scepter C balloon catheter was feasible in all cases. Vasospasms of the anterior cerebral artery were treated in ten cases. We didn't observe complications or vasospasm recurrences of the treated arteries. The temporal difference between distal vessels and the proximal reference vessel was significantly reduced from a mean of 53%, prior to dilatation, to 26% after the treatment. The difference between pre-dilatation and post-dilatation values was statistically significant for the anterior circulation at the proximal as well as at the distal vessels.
We successfully treated endovascularly patients suffering from cerebral vasospasms refractory to medical treatment using the Scepter C balloon catheter. We didn't observe any complications. The therapeutic effect could be easily and reliably assessed with the iFlow tool.
迟发性脑缺血是蛛网膜下腔出血（SAH）患者死亡和残疾的主要原因之一。经腔内球囊血管成形术（TBA）是治疗影响近端颅内动脉血管痉挛的一种治疗选择。
本研究旨在报告我们使用 Scepter C 球囊导管治疗因 SAH 引起的脑血管痉挛的经验，并使用 iFlow 工具评估术后结果。我们回顾了 2014 年至 2018 年在我院治疗的患者病例。患者通过经颅多普勒超声（TCD）和多模态计算机断层扫描进行筛查。如果存在明显的血管痉挛，患者将被转移到血管造影室进行治疗。我们使用 iFlow 工具通过测量和比较血管造影前后峰值密度值来量化和评估血管造影结果。
在所有病例中都可以使用 Scepter C 球囊导管。在前循环中，我们治疗了 10 例大脑前动脉血管痉挛。我们没有观察到治疗动脉的并发症或血管痉挛复发。扩张前和扩张后狭窄处远端血管与近端参考血管之间的时间差从平均 53%显著降低至 26%。在前循环中，近端和远端血管的扩张前和扩张后差值均具有统计学意义。
我们成功地使用 Scepter C 球囊导管治疗了对药物治疗有抗性的血管痉挛患者，没有观察到任何并发症。iFlow 工具可以轻松、可靠地评估治疗效果。
