罂粟碱
医学
溶栓
血管痉挛
麻醉
脑血管痉挛
改良兰金量表
缺血
颈内动脉
冲程(发动机)
蛛网膜下腔出血
心脏病学
内科学
心肌梗塞
缺血性中风
机械工程
工程类
作者
Gerasimos Baltsavias,Susmitha Yella,Rahman Abdul Al Shameri,Andreas R. Luft,Anton Valavanis
标识
DOI:10.1016/j.jstrokecerebrovasdis.2014.07.052
摘要
Background
The use of stent retrievers for mechanical thrombectomy in acute ischemic stroke may induce significant vasospasm, which at the early phases of reperfusion may be crucial for rethrombosis of the recanalized vessel. We aimed to study whether the use of intra-arterial papaverine in selected cases of vasospasm was associated with improved cerebral perfusion, arterial reocclusion, or increased hemorrhagic complications. Methods
We retrospectively studied 9 consecutive patients with large artery acute occlusion, treated with stent retriever and intra-arterial papaverine. Onset to administration of intravenous recombinant tissue-plasminogen activator time, baseline National Institute of Health Stroke Scale, time to reperfusion, number of passes of the stent retriever, modified Rankin Scale score at discharge, postprocedural hemorrhage, onset to reperfusion time, papaverine dose, and thrombolysis in cerebral infarction grade were recorded in all patients. Results
After papaverine administration, the caliber of the infused arteries and their flow was increased in all cases. In none of the treated cases a reocclusion occurred after papaverine infusion. In one of the studied patients (11%), a parenchymal bleeding occurred 36 hours postoperatively. Conclusions
This small study suggests that intra-arterial infusion of papaverine for the treatment of cerebral vasospasm after mechanical thrombectomy in acute ischemic stroke is effective and safe.
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