Abstract
Endovascular treatments for vasospasm after subarachnoid hemorrhage are typically performed for patients who are refractory to recommended medical therapies. We analyzed the current status of endovascular treatments based on the data of Japanese Registry of Neuroendovascular Therapy (JR-NET)3, and evaluated factors related to improvement of imaging findings and neurological condition, and to mechanical hemorrhage complications. We collected data of 1211 treatments performed from 2010 to 2014. Target vessels for treatments were anterior circulation (n = 1079), posterior circulation (n = 91), and both (n = 32); the distribution of vasospasm was the proximal vessel (n = 754) to the Circle of Willis, distal vessel (n = 329), and both (n = 119). Of the treatments, 948 cases (78.3%) were intra-arterial administration of vasodilators and 259 (21.4%) were percutaneous transluminal angioplasty (PTA); 879 cases were the first intervention. The treatment time from onset was within 3 h in 378 (31.2%) cases, between 3 and 6 h in 349 (28.8%) cases, and over 6 h in 245 (20.2%) cases. The statistically significant factors associated with improvement on imaging findings was the first treatment, and treatment within 3 h from onset compared with that after 6 h. Additionally, the first and early treatments after the symptoms were associated with significantly improved neurological condition. All complications of mechanical hemorrhage occurred along with PTA. The findings show that endovascular treatment for vasospasm was effective, especially for cases who suffered from symptomatic vasospasm with a short interval after onset.
| Original language | English |
|---|---|
| Pages (from-to) | 495-502 |
| Number of pages | 8 |
| Journal | Neurologia medico-chirurgica |
| Volume | 58 |
| Issue number | 12 |
| DOIs | |
| Publication status | Published - Jan 1 2018 |
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Keywords
- Endovascular treatment
- Neurological improvement
- Vasospasm
ASJC Scopus subject areas
- Surgery
- Clinical Neurology
Cite this
Endovascular treatment for vasospasm after aneurysmal subarachnoid hemorrhage based on data of JR-NET3. / JR-NET investigators.
In: Neurologia medico-chirurgica, Vol. 58, No. 12, 01.01.2018, p. 495-502.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Endovascular treatment for vasospasm after aneurysmal subarachnoid hemorrhage based on data of JR-NET3
AU - JR-NET investigators
AU - Imamura, Hirotoshi
AU - Sakai, Nobuyuki
AU - Satow, Tetsu
AU - Iihara, Koji
AU - Ezura, Masayuki
AU - Hyodo, Akio
AU - Miyachi, Shigeru
AU - Miyamoto, Susumu
AU - Nagai, Yoji
AU - Nishimura, Kunihiro
AU - Toyoda, Kazunori
AU - Fujinaka, Toshiyuki
AU - Higashi, Toshio
AU - Hirohata, Masaru
AU - Ishii, Akira
AU - Ito, Yasushi
AU - Kuwayama, Naoya
AU - Oishi, Hidenori
AU - Matsumaru, Yuji
AU - Matsumoto, Yasushi
AU - Nakahara, Ichiro
AU - Sakai, Chiaki
AU - Sugiu, Kenji
AU - Terada, Tomoaki
AU - Yoshimura, Shinichi
PY - 2018/1/1
Y1 - 2018/1/1
N2 - Endovascular treatments for vasospasm after subarachnoid hemorrhage are typically performed for patients who are refractory to recommended medical therapies. We analyzed the current status of endovascular treatments based on the data of Japanese Registry of Neuroendovascular Therapy (JR-NET)3, and evaluated factors related to improvement of imaging findings and neurological condition, and to mechanical hemorrhage complications. We collected data of 1211 treatments performed from 2010 to 2014. Target vessels for treatments were anterior circulation (n = 1079), posterior circulation (n = 91), and both (n = 32); the distribution of vasospasm was the proximal vessel (n = 754) to the Circle of Willis, distal vessel (n = 329), and both (n = 119). Of the treatments, 948 cases (78.3%) were intra-arterial administration of vasodilators and 259 (21.4%) were percutaneous transluminal angioplasty (PTA); 879 cases were the first intervention. The treatment time from onset was within 3 h in 378 (31.2%) cases, between 3 and 6 h in 349 (28.8%) cases, and over 6 h in 245 (20.2%) cases. The statistically significant factors associated with improvement on imaging findings was the first treatment, and treatment within 3 h from onset compared with that after 6 h. Additionally, the first and early treatments after the symptoms were associated with significantly improved neurological condition. All complications of mechanical hemorrhage occurred along with PTA. The findings show that endovascular treatment for vasospasm was effective, especially for cases who suffered from symptomatic vasospasm with a short interval after onset.
AB - Endovascular treatments for vasospasm after subarachnoid hemorrhage are typically performed for patients who are refractory to recommended medical therapies. We analyzed the current status of endovascular treatments based on the data of Japanese Registry of Neuroendovascular Therapy (JR-NET)3, and evaluated factors related to improvement of imaging findings and neurological condition, and to mechanical hemorrhage complications. We collected data of 1211 treatments performed from 2010 to 2014. Target vessels for treatments were anterior circulation (n = 1079), posterior circulation (n = 91), and both (n = 32); the distribution of vasospasm was the proximal vessel (n = 754) to the Circle of Willis, distal vessel (n = 329), and both (n = 119). Of the treatments, 948 cases (78.3%) were intra-arterial administration of vasodilators and 259 (21.4%) were percutaneous transluminal angioplasty (PTA); 879 cases were the first intervention. The treatment time from onset was within 3 h in 378 (31.2%) cases, between 3 and 6 h in 349 (28.8%) cases, and over 6 h in 245 (20.2%) cases. The statistically significant factors associated with improvement on imaging findings was the first treatment, and treatment within 3 h from onset compared with that after 6 h. Additionally, the first and early treatments after the symptoms were associated with significantly improved neurological condition. All complications of mechanical hemorrhage occurred along with PTA. The findings show that endovascular treatment for vasospasm was effective, especially for cases who suffered from symptomatic vasospasm with a short interval after onset.
KW - Endovascular treatment
KW - Neurological improvement
KW - Vasospasm
UR - http://www.scopus.com/inward/record.url?scp=85058762733&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85058762733&partnerID=8YFLogxK
U2 - 10.2176/nmc.oa.2018-0212
DO - 10.2176/nmc.oa.2018-0212
M3 - Article
C2 - 30464151
AN - SCOPUS:85058762733
VL - 58
SP - 495
EP - 502
JO - Neurologia Medico-Chirurgica
JF - Neurologia Medico-Chirurgica
SN - 0470-8105
IS - 12
ER -