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Journal of Korean Neurosurgical Society 2002;32(2): 89-95.
Papaverine Angioplasty for Cerebral Vasospasm: Preliminary Report.
O Ki Kwon, Dong Yeob Lee, Chang Wan Oh, Moon Hee Han, Chae Yong Kim, Dae Hee Han
1Department of Neurosurgery, Seoul Paik Hostpial, Inje University, Seoul, Korea.
2Department of Neurosurgery, Seoul National University College of Medicine, Seoul, Korea.
3Department of Radiology, Seoul National University College of Medicine, Seoul, Korea.
4Medical Research Center, Seoul National University, Seoul, Korea.
We present an evaluation of the clinical outcome and an investigation of the optimal use of papaverine angioplasty for the treatment of symptomatic vasospasm following subarachnoid hemorrhage.
The authors retrospectively analyzed 24 cases of symptomatic vasospasm treated by papaverine angioplasty from July 1994 to February 1998. Detailed clinical features and detailed techniques of papaverine angioplasty including sex, age, symptoms, time interval from symptom onset to angioplasty, papaverine dose, concentration and duration of infusion were investigated.
After papaverine angioplasty, immediate angiographic vasodilatation was achieved in 23 cases (96%). Fifty eight percent showed clinical improvement within 24 hours but symptomatic vasospasm recurred in 21% of them. Retreatment with papaverine for the recurred cases showed a less response than the initial treatment. Statistical analyses showed that time interval from symptom onset to angioplasty was the factor related to the effects of papaverine angioplasty.
Our study shows that optimal timing of papaverine angioplasty is very important for clinical improvement.
Key Words: SAH; Vasospasm; Papaverine angioplasty
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