Prophylactic thrombosis to prevent new bleeding and to delay aneurysm surgery

Kazushi Kinugasa, Shinya Mandai, Ichiro Kamata, Koji Tokunaga, Kenji Sugiu, Akira Handa, Hiroyuki Nakashima, Takashi Ohmoto

Research output: Contribution to journalArticle

20 Citations (Scopus)

Abstract

SIX ANEURYSMS IN five patients with acute aneurysmal subarachnoid hemorrhages were treated with direct thrombosis using cellulose acetate polymer within 4 hours of rupture. The aneurysms involved the internal carotid and posterior communicating arteries (two patients), the anterior choroidal artery (one patient), the bifurcation of the basilar artery (one patient), and the middle cerebral artery (two patients). Four patients underwent aggressive volume expansion after direct thrombosis with cellulose acetate polymer. The aneurysms remained thrombosed until operations on the necks were performed 2 to 7 weeks after the subarachnoid hemorrhages. Three patients were given intrathecal tissue plasminogen activator. One patient, who remained at neurological Grade V, was not treated surgically and died from cardiac failure. Five aneurysms in the remaining four patients were successfully clipped. These preliminary data suggest that immediate aneurysmal thrombosis, then aggressive preoperative prophylactic volume expansion and/or administration of intrathecal tissue plasminogen activator, can help prevent new bleeding and reduce delayed cerebral ischemia in patients after aneurysmal subarachnoid hemorrhages.

Original languageEnglish
Pages (from-to)661-667
Number of pages7
JournalNeurosurgery
Volume36
Issue number4
Publication statusPublished - 1995

Fingerprint

Aneurysm
Thrombosis
Hemorrhage
Subarachnoid Hemorrhage
Tissue Plasminogen Activator
Polymers
Arteries
Basilar Artery
Middle Cerebral Artery
Brain Ischemia
Rupture
Neck
Heart Failure

Keywords

  • Aneurysm
  • Cellulose acetate polymer
  • Cerebral vasospasm
  • Delayed aneurysm surgery
  • Hypertensive hypervolemic therapy
  • Spinal drainage
  • Tissue plasminogen activator

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery

Cite this

Kinugasa, K., Mandai, S., Kamata, I., Tokunaga, K., Sugiu, K., Handa, A., ... Ohmoto, T. (1995). Prophylactic thrombosis to prevent new bleeding and to delay aneurysm surgery. Neurosurgery, 36(4), 661-667.

Prophylactic thrombosis to prevent new bleeding and to delay aneurysm surgery. / Kinugasa, Kazushi; Mandai, Shinya; Kamata, Ichiro; Tokunaga, Koji; Sugiu, Kenji; Handa, Akira; Nakashima, Hiroyuki; Ohmoto, Takashi.

In: Neurosurgery, Vol. 36, No. 4, 1995, p. 661-667.

Research output: Contribution to journalArticle

Kinugasa, K, Mandai, S, Kamata, I, Tokunaga, K, Sugiu, K, Handa, A, Nakashima, H & Ohmoto, T 1995, 'Prophylactic thrombosis to prevent new bleeding and to delay aneurysm surgery', Neurosurgery, vol. 36, no. 4, pp. 661-667.
Kinugasa K, Mandai S, Kamata I, Tokunaga K, Sugiu K, Handa A et al. Prophylactic thrombosis to prevent new bleeding and to delay aneurysm surgery. Neurosurgery. 1995;36(4):661-667.
Kinugasa, Kazushi ; Mandai, Shinya ; Kamata, Ichiro ; Tokunaga, Koji ; Sugiu, Kenji ; Handa, Akira ; Nakashima, Hiroyuki ; Ohmoto, Takashi. / Prophylactic thrombosis to prevent new bleeding and to delay aneurysm surgery. In: Neurosurgery. 1995 ; Vol. 36, No. 4. pp. 661-667.
@article{3e83be3ad1e643c68fcd92945d604d90,
title = "Prophylactic thrombosis to prevent new bleeding and to delay aneurysm surgery",
abstract = "SIX ANEURYSMS IN five patients with acute aneurysmal subarachnoid hemorrhages were treated with direct thrombosis using cellulose acetate polymer within 4 hours of rupture. The aneurysms involved the internal carotid and posterior communicating arteries (two patients), the anterior choroidal artery (one patient), the bifurcation of the basilar artery (one patient), and the middle cerebral artery (two patients). Four patients underwent aggressive volume expansion after direct thrombosis with cellulose acetate polymer. The aneurysms remained thrombosed until operations on the necks were performed 2 to 7 weeks after the subarachnoid hemorrhages. Three patients were given intrathecal tissue plasminogen activator. One patient, who remained at neurological Grade V, was not treated surgically and died from cardiac failure. Five aneurysms in the remaining four patients were successfully clipped. These preliminary data suggest that immediate aneurysmal thrombosis, then aggressive preoperative prophylactic volume expansion and/or administration of intrathecal tissue plasminogen activator, can help prevent new bleeding and reduce delayed cerebral ischemia in patients after aneurysmal subarachnoid hemorrhages.",
keywords = "Aneurysm, Cellulose acetate polymer, Cerebral vasospasm, Delayed aneurysm surgery, Hypertensive hypervolemic therapy, Spinal drainage, Tissue plasminogen activator",
author = "Kazushi Kinugasa and Shinya Mandai and Ichiro Kamata and Koji Tokunaga and Kenji Sugiu and Akira Handa and Hiroyuki Nakashima and Takashi Ohmoto",
year = "1995",
language = "English",
volume = "36",
pages = "661--667",
journal = "Neurosurgery",
issn = "0148-396X",
publisher = "Lippincott Williams and Wilkins",
number = "4",

}

TY - JOUR

T1 - Prophylactic thrombosis to prevent new bleeding and to delay aneurysm surgery

AU - Kinugasa, Kazushi

AU - Mandai, Shinya

AU - Kamata, Ichiro

AU - Tokunaga, Koji

AU - Sugiu, Kenji

AU - Handa, Akira

AU - Nakashima, Hiroyuki

AU - Ohmoto, Takashi

PY - 1995

Y1 - 1995

N2 - SIX ANEURYSMS IN five patients with acute aneurysmal subarachnoid hemorrhages were treated with direct thrombosis using cellulose acetate polymer within 4 hours of rupture. The aneurysms involved the internal carotid and posterior communicating arteries (two patients), the anterior choroidal artery (one patient), the bifurcation of the basilar artery (one patient), and the middle cerebral artery (two patients). Four patients underwent aggressive volume expansion after direct thrombosis with cellulose acetate polymer. The aneurysms remained thrombosed until operations on the necks were performed 2 to 7 weeks after the subarachnoid hemorrhages. Three patients were given intrathecal tissue plasminogen activator. One patient, who remained at neurological Grade V, was not treated surgically and died from cardiac failure. Five aneurysms in the remaining four patients were successfully clipped. These preliminary data suggest that immediate aneurysmal thrombosis, then aggressive preoperative prophylactic volume expansion and/or administration of intrathecal tissue plasminogen activator, can help prevent new bleeding and reduce delayed cerebral ischemia in patients after aneurysmal subarachnoid hemorrhages.

AB - SIX ANEURYSMS IN five patients with acute aneurysmal subarachnoid hemorrhages were treated with direct thrombosis using cellulose acetate polymer within 4 hours of rupture. The aneurysms involved the internal carotid and posterior communicating arteries (two patients), the anterior choroidal artery (one patient), the bifurcation of the basilar artery (one patient), and the middle cerebral artery (two patients). Four patients underwent aggressive volume expansion after direct thrombosis with cellulose acetate polymer. The aneurysms remained thrombosed until operations on the necks were performed 2 to 7 weeks after the subarachnoid hemorrhages. Three patients were given intrathecal tissue plasminogen activator. One patient, who remained at neurological Grade V, was not treated surgically and died from cardiac failure. Five aneurysms in the remaining four patients were successfully clipped. These preliminary data suggest that immediate aneurysmal thrombosis, then aggressive preoperative prophylactic volume expansion and/or administration of intrathecal tissue plasminogen activator, can help prevent new bleeding and reduce delayed cerebral ischemia in patients after aneurysmal subarachnoid hemorrhages.

KW - Aneurysm

KW - Cellulose acetate polymer

KW - Cerebral vasospasm

KW - Delayed aneurysm surgery

KW - Hypertensive hypervolemic therapy

KW - Spinal drainage

KW - Tissue plasminogen activator

UR - http://www.scopus.com/inward/record.url?scp=0028939753&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0028939753&partnerID=8YFLogxK

M3 - Article

C2 - 7596494

AN - SCOPUS:0028939753

VL - 36

SP - 661

EP - 667

JO - Neurosurgery

JF - Neurosurgery

SN - 0148-396X

IS - 4

ER -