RESUMO
Cerebral vasospasm remains a leading cause of death and disability in patients with aneurysmal subarachnoid hemorrhage. When vasospasm becomes refractory to maximal medical treatment, endovascular therapies may be considered as an option to increase cerebral blood flow to prevent cerebral infarction. Endovascular techniques include transluminal balloon angioplasty and intra-arterial infusion of vasorelaxants. This article reviews the various endovascular techniques for the treatment of cerebral vasospasm and discusses the mechanisms of action, techniques of administration, clinical results, and limitations of these treatment strategies.
Assuntos
Angioplastia com Balão , Bloqueadores dos Canais de Cálcio/uso terapêutico , Hemorragia Subaracnóidea/complicações , Vasodilatadores/administração & dosagem , Vasoespasmo Intracraniano/etiologia , Vasoespasmo Intracraniano/terapia , Humanos , Infusões Intra-ArteriaisRESUMO
El vasospasmo cerebral es una de las principales causas de morbimortalidad en los pacientes con hemorragia subaracnoidea por rotura de un aneurisma cerebral. Cuando el vasospasmo se hace resistente al tratamiento médico máximo, el tratamiento endovascular es una opción terapéutica para incrementar el flujo sanguíneo cerebral y evitar lesiones isquémicas cerebrales. Los rápidos avances en técnicas endovasculares permiten utilizar la angioplastia transluminal percutánea y la infusión intraarterial de diversos fármacos vasodilatadores para revertir el vasospasmo. En este artículo se revisan las diferentes técnicas endovasculares disponibles y se describen sus mecanismos de acción, técnicas de administración, resultados clínicos y complicaciones
Cerebral vasospasm remains a leading causeof death and disability in patients with aneurysmalsubarachnoid hemorrhage. When vasospasm becomesrefractory to maximal medical treatment,endovascular therapies may be considered as anoption to increase cerebral blood flow to preventcerebral infarction. Endovascular techniques includetransluminal balloon angioplasty and intraarterialinfusion of vasorelaxants.This article reviews the various endovasculartechniques for the treatment of cerebral vasospasmand discusses the mechanisms of action,techniques of administration, clinical results,and limitations of these treatment strategies