التفاصيل البيبلوغرافية
| العنوان: |
Distal cerebral vasospasm treatment following aneurysmal subarachnoid hemorrhage using the Comaneci device: technical feasibility and single-center preliminary results. |
| المؤلفون: |
Thiery, Louis, Carle, Xavier, Testud, Benoit, Boulouis, Gregoire, Habert, Paul, Tradi, Farouk, Reyre, Anthony, Lehmann, Pierre, Dory-Lautrec, Philippe, Stellmann, Jan-Patrick, Girard, Nadine, Brunel, Herve, Hak, Jean-Francois |
| المصدر: |
Journal of NeuroInterventional Surgery; Apr2023, Vol. 15 Issue 4, p325-329, 6p |
| مصطلحات موضوعية: |
TRANSLUMINAL angioplasty, CONFIDENCE intervals, THERAPEUTIC embolization, RETROSPECTIVE studies, ACQUISITION of data, CEREBRAL vasospasm, SUBARACHNOID hemorrhage, TREATMENT effectiveness, INTER-observer reliability, MEDICAL records, DESCRIPTIVE statistics, ENDOVASCULAR surgery, STATISTICAL correlation |
| مستخلص: |
Background Balloon-assisted mechanical angioplasty for cerebral vasospasm following aneurysmal subarachnoid hemorrhage (aSAH) has a number of limitations, including transient occlusion of the spastic blood vessel. Comaneci is an FDA-approved device for temporary coil embolization assistance which has recently also been approved for the treatment of distal symptomatic refractory vasospasm. We aimed to report the feasibility, efficacy and safety of our experience with Comaneci angioplasty for refractory distal vasospasm (up to the second segment of the cerebral arteries) following aSAH. Methods This is a retrospective analysis of a prospective series of 18 patients included between April 2019 and June 2021 with aSAH and symptomatic vasospasm refractory to medical therapy, who were treated using Comaneci-17-asssisted mechanical distal angioplasty. Immediate angiographic results, procedure-related complications, and clinical outcomes were assessed. Inter-rater reliability of the scores was determined using the intraclass correlation coefficient. Results Comaneci-assisted distal angioplasty was performed in 18 patients, corresponding to 31 target arteries. All distal anterior segments were easily accessible with the Comaneci-17 device. Vasospasm improvement after Comaneci mechanical angioplasty was seen in 22 distal arteries (71%) (weighted Cohen's kappa (κw) 0.73, 95% CI 0.69 to 0.93). Vasospasm recurrence occurred in three patients (16.67%) and delayed cerebral infarction in three patients (16.67%), with a mean±SD delay between onset of symptoms and imaging follow-up (MRI/CT) of 32.61±8.93 days (κw 0.98, 95% CI 0.88 to 1). Conclusion This initial experience suggests that distal mechanical angioplasty performed with the Comaneci-17 device for refractory vasospasm following aSAH seems to be safe, with good feasibility and efficacy. [ABSTRACT FROM AUTHOR] |
|
Copyright of Journal of NeuroInterventional Surgery is the property of BMJ Publishing Group and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.) |
| قاعدة البيانات: |
Complementary Index |
Full Text Finder