Endovascular treatment versus standard management for cerebral vasospasm after aneurysmal subarachnoid haemorrhage

Salazar-Díaz, Luis Carlos; Lozano-Castillo, Alfonso; Neira-Escobar, Fabian; Grillo‐Ardila, Carlos Fernando; Arevalo, Octavio; Krings, Timo

doi:10.1002/14651858.cd013713

Cited by 1 publication

(2 citation statements)

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“…With respect to the treatment of posthemorrhagic vasospasm, there is currently still significant heterogeneity regarding the implementation of EST [47]. Insight from meta-analyses, Cochrane reviews, and multinational registry databases should still be taken into consideration for standardization and large randomized studies should be performed [13,78]. However, the path to definitive evidence supporting EST is still long which can be attributed to the repeatedly sobering results of individual studies on this topic [79,80].…”

Section: Discussionmentioning

confidence: 99%

“…Was die Therapie des posthämorrhagischen Vasospasmus angeht, ist gerade bei der Durchführung von EST immer noch eine große Heterogenität zu beobachten [47]. Nach wie vor sollten für Vereinheitlichungen natürlich Erkenntnisse aus Metaanalysen, Cochrane Reviews und multinational gespeisten Registerdatenbanken Beachtung finden und groß angelegte randomisierte Studien angestrebt werden [13,78]. Der Weg hin zur Evidenz von EST ist aber weiterhin lang, was auch wiederkehrend ernüchternden Resultaten aus einzelnen Studien zu diesem Thema zuzuschreiben ist [79,80].…”

Section: Andere Instrumenteunclassified

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Neuroradiological diagnosis and therapy of cerebral vasospasm after subarachnoid hemorrhage

Neumann,

Schacht,

Schramm

2024

Rofo

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Background Cerebral damage after aneurysmal subarachnoid hemorrhage (SAH) results from various, sometimes unrelated causes. After the initial hemorrhage trauma with an increase in intracranial pressure, induced vasoconstriction, but also microcirculatory disturbances, inflammation and pathological electrophysiological processes (cortical spreading depolarization) can occur in the course of the disease, resulting in delayed cerebral ischemia (DCI). In the neuroradiological context, cerebral vasospasm (CVS) remains the focus of diagnostic imaging and endovascular therapy as a frequent component of the genesis of DCI. Methods The amount of blood leaked during aneurysm rupture (which can be detected by CT, for example) correlates with the occurrence and severity of CVS. CT perfusion is then an important component in determining the indication for endovascular spasm therapies (EST). These include intra-arterial drug administration (also as long-term microcatheter treatment) and mechanical procedures (balloon angioplasty, vasodilatation using other instruments such as stent retrievers, stenting). Conclusion This review summarizes the current findings on the diagnosis and treatment of CVS after aneurysmal SAH from a neuroradiological perspective, taking into account the complex and up-to-date international literature. Key Points Citation Format

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Section: Discussionmentioning

confidence: 99%