Endovascular Therapy for Cerebral Vasospasm Following Aneurysmal Subarachnoid Haemorrhage

Lai, YTA; Chu, Ching-Chi; Sung, HT; Cw, Tang; Leung, KW; Lo, SWS; Khoo, LSJ

doi:10.12809/hkjr1715387

Cited by 6 publications

(5 citation statements)

References 10 publications

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“…2 Selective infusion cerebral vasospasm in subarachnoid hemorrhage of IA vasodilators to branches of small arteries is still beneficial although the effect is not longlasting. 1 The potential disadvantages of this therapy are hypotension and increase of ICP related to vasodilatation and vascular relaxation. 2 Some medication that could be administrated IA include: 2 a. Papaverine Papaverine is group of benzylisoquinoline alkaloid, used IA for treatment of vasospasm since 1992.…”

Section: Intra-arterial Pharmacological Therapymentioning

confidence: 99%

“…The safety and efficacy of verapamil IA was reported in some cases. 1 Verapamil is a calcium channel blocker. 2 The mechanism is to decrease the calcium influx in smooth muscle cells which results in vasodilatation.…”

Section: Verapamilmentioning

confidence: 99%

“…2 Lai et al has shown that endovascular therapy could be an option in treating vasospasm caused by aSAH. 1 The study evaluated 7 aSAH grade 4 patients, and vasospasm was measured by CTA and/or TCD. The endovascular therapy underwent after 4-12 days and followed for at least 10 months.…”

Section: Verapamilmentioning

confidence: 99%

“…2 SAH is closely related to 40% of mortality in patients and may result into vasospasm that can lead to delayed cerebral ischemia. 1 Vasospasm is the main cause of mortality and morbidity after SAH. 2 About 67% of aneurysmal subarachnoid hemorrhage (aSAH) will result into vasospasm and 10-45% of vasospasm victims will develop infarct.…”

Section: Introductionmentioning

confidence: 99%

“…2 About 67% of aneurysmal subarachnoid hemorrhage (aSAH) will result into vasospasm and 10-45% of vasospasm victims will develop infarct. 1 Angiographic vasospasm occurs in 70% and clinical vasospasm in about 40% of SAH patients. About 30% of the patients with clinical vasospasm will develop a delayed ischemic neurological deficit (DIND) and suffer from mortality or severe deficits.…”

Section: Introductionmentioning

confidence: 99%

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Management of cerebral vasospasm in subarachnoid hemorrhage

Prahaztuti

Hidayati

Sani

2019

APIC

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Subarachnoid hemorrhage (SAH) has been shown to result in cerebral vasospasm at day 4 to day 14, which is the main cause of mortality and morbidity after SAH. Outcome after SAH depends on many factors, including the severity of the event, medical management, and prevention of several serious complications. The principal goal in management of vasospasm after SAH is to prevent delayed ischemic neurological deficit (DIND) by decreasing intracranial pressure (ICP), optimizing cerebral oxygen demand rate and improving cerebral blood flow (CBF). Therapeutic management has been applied to prevent or treat vasospasm, including hemodynamic therapy, and endovascular therapy. Endovascular therapies, including mechanical angioplasty and chemical angioplasty with administration of intra-arterial (IA) vasodilator, have been widely used and given a good outcome. The purpose of this article is to describe the management of vasospasm including medical management and endovascular treatment. This review will describe the treatment modalities and management strategies to treat vasospasm.Abbreviations: SAH – subarachnoid hemorrhage; aSAH – aneurysmal subarachnoid hemorrhage; TCD – transcranial Doppler; ROS – reactive oxygen species; ICAM – intercellular adhesion molecule; VCAM – vascular cell adhesion molecule; IL – interleukin; CTA – computed tomography angiography; MRA – magnetic resonance angiography; CBF – cerebral blood flow; DIND – delayed ischemic neurological deficit; RCT - randomized controlled trialsCitation: Prahaztuti D, Hidayati HB, Sani AF. Management of cerebral vasospasm in subarachnoid hemorrhage. Anaesth Pain & Intensive Care 2018;22(3 Suppl 1):S58-S66.Received: 19 Oct 2018 Reviewed: 4, 11 Nov 2018 Accepted: 12 Nov 2018

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Section: Intra-arterial Pharmacological Therapymentioning

confidence: 99%

Section: Verapamilmentioning

confidence: 99%

Section: Verapamilmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Management of cerebral vasospasm in subarachnoid hemorrhage

Prahaztuti

Hidayati

Sani

2019

APIC

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Overcoming the rising incidence and evolving mechanisms of antibiotic resistance by novel drug delivery approaches – An overview

Lai

Leung

et al. 2022

Advanced Drug Delivery Reviews

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Antimicrobial-resistant CC17 Enterococcus faecium: The past, the present and the future

Lee

Pang

Abraham

et al. 2019

Journal of Global Antimicrobial Resistance

131

102

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Enterococcus faecium are robust opportunistic pathogens that are most commonly found as commensals of the human and animal gut but can also survive in the environment. Since the introduction and use of antimicrobials, E. faecium have been found to rapidly acquire resistance genes which when expressed can effectively circumvent the effects of most antimicrobials. The rapid acquisition of multiple antimicrobial resistances has led to the adaptation of specific E. faecium clones in the hospital environment collectively known as clonal complex (CC)17. CC17 E. faecium are responsible for a significant portion of hospital-associated infections, which can cause severe morbidity and mortality. Here, we review the history of E. faecium from commensal to a significant hospital-associated pathogen, its robust phenotypic characteristics, commonly used laboratory typing schemes and antimicrobial resistances with a focus on vancomycin and its associated mechanism of resistance. Finally, we review the global epidemiology of vancomycin resistant E. faecium and potential solutions to problems faced in public health.

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Endovascular Therapy for Cerebral Vasospasm Following Aneurysmal Subarachnoid Haemorrhage

Cited by 6 publications

References 10 publications

Management of cerebral vasospasm in subarachnoid hemorrhage

Management of cerebral vasospasm in subarachnoid hemorrhage

Overcoming the rising incidence and evolving mechanisms of antibiotic resistance by novel drug delivery approaches – An overview

Antimicrobial-resistant CC17 Enterococcus faecium: The past, the present and the future

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