Superselective intra-arterial infusion of papaverine for the treatment of cerebral vasospasm after subarachnoid hemorrhage.
Superselective intra-arterial infusion of papaverine for the treatment of cerebral vasospasm after subarachnoid hemorrhage.
复制标题
超选择性动脉内注射罂粟碱治疗蛛网膜下腔出血后脑血管痉挛。
作者：
Y. Kaku;Y. Yonekawa;T. Tsukahara;K. Kazekawa
本文报道了超选择性动脉内注射罂粟碱治疗蛛网膜下腔出血后脑血管痉挛的方法。对10例症状性血管痉挛患者的37个血管区域按以下方案进行治疗。血管成形术分两步进行。首先，使用硅胶气囊扩张颈内动脉和大脑中动脉近端。然后将硅胶渗漏球囊或Tracker-18导管插入血管成形术球囊导管无法触及的血管痉挛部位或其近端，以超选择性地注入0.2%罂粟碱。37个血管区域中有34个血管扩张成功，10个患者中有8个在手术后神经功能改善。输注罂粟碱无严重副作用。为了提供足够的药物浓度，必须在痉挛血管的近端注入罂粟碱，而且应该在动脉失去恢复正常管腔大小的能力之前尽早进行输液。超选择性动脉内注射罂粟碱是治疗症状性血管痉挛的一种替代方法。
This report describes the successful treatment of cerebral vasospasm after subarachnoid hemorrhage with superselective intra-arterial infusion of papaverine hydrochloride. Thirty-seven vascular territories in 10 patients with symptomatic vasospasm were treated according to the following protocol. Percutaneous transluminal angioplasty was performed in two steps. First, a silicone balloon was used for dilation of the internal carotid artery and the proximal portions of the middle cerebral artery. A silicone leak balloon or Tracker-18 catheter was then introduced into or just proximal to the site of vasospasm not accessible to the angioplasty balloon catheter for superselective infusion of 0.2% papaverine. Thirty-four of 37 vascular territories were successfully dilated, and eight of 10 patients showed improvement in neurological function after the procedure. There were no serious side effects due to infusion of papaverine. It is essential to infuse the papaverine just proximal to the spastic vessels in order to deliver sufficient concentration of drug, and infusion should be carried out as early as possible before the artery loses its ability to return to a normal luminal size. Superselective intraarterial infusion of papaverine is an alternative method of treatment for symptomatic vasospasm.
兔基底动脉慢性脑血管痉挛可逆和不可逆成分的纵向时间过程。
影响因子：
4.1
作者：
Vorkapic,P;Bevan,RD;Bevan,JA
通讯作者：
Bevan,JA
影响因子：
4.1
作者：
NEWELL, DW;ESKRIDGE, JM;WINN, HR
通讯作者：
WINN, HR