Intra-arterial papaverine infusions for the treatment of cerebral vasospasm induced by aneurysmal subarachnoid hemorrhage

@article{Liu2005IntraarterialPI,
  title={Intra-arterial papaverine infusions for the treatment of cerebral vasospasm induced by aneurysmal subarachnoid hemorrhage},
  author={James K.C. Liu and William T. Couldwell},
  journal={Neurocritical Care},
  year={2005},
  volume={2},
  pages={124-132}
}
Cerebral vasospasm secondary to aneurysmal subarachnoid hemorrhage that has become refractory to maximal medical management can be treated with selective intra-arterial papaverine infusions. Papaverine is a potent vasodilator of the proximal, intermediate, and distal cerebral arteries and can improve cerebral blood flow (CBF). When infused intra-arterially using endovascular microcatheter techniques, papaverine can effectively increase angiographic vessel diameter, decrease prolonged cerebral… 

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Intra-Arterial Nimodipine Infusion for Cerebral Vasospasm in Patients with Aneurysmal Subarachnoid Hemorrhage

  • W. ChoH. Kang M.H. Han
  • Medicine
    Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences
  • 2011
Nimodipine can be recommended as an effective and safe intra-arterial agent for the treatment of symptomatic vasospasm after aSAH and showed satisfactory outcomes.
...

References

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In this preliminary anecdotal series of 12 patients who were candidates for balloon angioplasty, vasospasm was treated instead with intra-arterial papaverine, and marked angiographic reversal of the arterial narrowing following papaversine infusion and dramatic reversal of profound neurological deficits were shown.

Superselective intra-arterial infusion of papaverine for the treatment of cerebral vasospasm after subarachnoid hemorrhage.

The successful treatment of cerebral vasospasm after subarachnoid hemorrhage with superselective intra-arterial infusion of papaverine hydrochloride and eight of 10 patients showed improvement in neurological function after the procedure.

Efficacy of multiple intraarterial papaverine infusions for improvement in cerebral circulation time in patients with recurrent cerebral vasospasm.

The preliminary results indicate that multiple intraarterial papaverine treatments consistently improve cerebral circulation times, even with repeated infusions in cases of recurrent vasospasm.

Intraarterial papaverine infusion for cerebral vasospasm after subarachnoid hemorrhage.

Papaverine was effective in dilating narrowed arteries in most patients with symptomatic vasospasm caused by subarachnoid hemorrhage with encouraging clinical results with no recurrence of neurologic deterioration in those patients who responded well to papaverine.

Intracranial pressure changes induced during papaverine infusion for treatment of vasospasm.

A careful, titrated infusion of papaverine, with constant reference to the patient's ICP, blood pressure, and pulse rate, minimizes the transient increase in ICP while maintaining adequate blood pressure and CPP.

Paradoxical aggravation of vasospasm with papaverine infusion following aneurysmal subarachnoid hemorrhage. Case report.

This is the first clinical case to illustrate a paradoxical effect of intraarterial papaverine treatment for vasospasm following aneurysmal SAH, and possible mechanisms of this paradoxical response and potential therapeutic reactions are reviewed.

Repeat intra-arterial papaverine for recurrent cerebral vasospasm after subarachnoid haemorrhage

The preliminary results suggest that repeat papaverine infusion may be a way of controlling recurrent or recalcitrant vasospasm.

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Test the hypothesis that balloon angioplasty is superior to papaverine infusion for the treatment of proximal anterior circulation arterial vasospasm following subarachnoid hemorrhage by comparing mean pre- and posttreatment velocity.
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