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Clinical Neuroradiology

, Volume 29, Issue 4, pp 751–761 | Cite as

Stent-Retriever Angioplasty for Recurrent Post-Subarachnoid Hemorrhagic Vasospasm – A Single Center Experience with Long-Term Follow-Up

  • Hyon-Jo Kwon
  • Jeong-Wook LimEmail author
  • Hyeon-Song Koh
  • BumSoo Park
  • Seung-Won Choi
  • Seon-Hwan Kim
  • Jin-Young Youm
  • Shi-Hun Song
Original Article

Abstract

Purpose

We report our experience of using stent-retrievers for recurrent cerebral vasospasm (CVS) secondary to aneurysmal subarachnoid hemorrhage (aSAH).

Methods

We performed a retrospective review of our prospectively maintained institutional database to identify all patients with recurrent CVS and treated with stent-retrievers between April 2011 and May 2017. All patients were initially treated with intra-arterial (IA) vasodilators and were subsequently re-treated with stent-retrievers if they developed recurrent vasospasm. Patients were categorized into two groups, those in which IA vasodilators were given again prior to the stent-retriever deployment (VD-first) and those in which the stent-retriever was deployed first and IA vasodilators were given subsequently (SR-first).

Results

We identified 12 patients (7 females, mean age 54.9 years), 5 in the VD-first and 7 in the SR-first cohorts. Stent-retriever lumen dilatation was attempted in 53 segments (VD-first 14, SR-first 39). Stent-retriever deployment was technically feasible in all cases. Vasodilation occurred in 71.4% (10/14 segments) in the VD-first group and 82.1% (32/39 segments) in SR-first group. Additional treatment was required in 5 segments. There was no recurrent vasospasm in the SR-first group; however, 3 patients (60%) in the VD-first group showed recurrent vasospasm. No angiographical abnormality was found at long-term follow-up (7 patients, mean 29.1 months).

Conclusion

The use of stent-retrievers to treat cerebral vasospasm is technically feasible and can cause long-term vasodilatation; however, this effect is maximized if stent-retrievers are used prior to infusion of IA vasodilators.

Keywords

SAH Angioplasty Recurrent vasospasm Stentriever 

Abbreviations

Stentriever

Stent-retriever

TBA

Transluminal balloon angioplasty

Notes

Funding

This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.

Compliance with ethical guidelines

Conflict of interest

H.-J. Kwon, J.-W. Lim, H.-S. Koh, B. Park, S.-W. Choi, S.-H. Kim, J.-Y. Youm and S.-H. Song declare that they have no competing interests.

Ethical standards

Approval by the institutional review board at our institute and acquisition of informed consent from the patient and/or their families prior to the procedures were completed before this study.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Hyon-Jo Kwon
    • 1
  • Jeong-Wook Lim
    • 1
    Email author
  • Hyeon-Song Koh
    • 1
  • BumSoo Park
    • 1
  • Seung-Won Choi
    • 1
  • Seon-Hwan Kim
    • 1
  • Jin-Young Youm
    • 1
  • Shi-Hun Song
    • 1
  1. 1.Department of Neurosurgery, Daejeon-Chungnam Regional Cerebrovascular CenterChungnam National University Medical School and HospitalDaejeonKorea (Republic of)

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