Intra-arterial Administration of Papaverine during Mechanical Thrombectomy for Acute Ischemic Stroke

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
出处
期刊:Journal of stroke and cerebrovascular diseases [Elsevier]
卷期号:24 (1): 41-47 被引量:11
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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