- Media Sphera
- Publishers
Iu.V. Pilipenko
FGBU "NII neĭrokhirurgii im. akad. N.N. Burdenko" RAMN, Moskva
M.D. Varyukhina
Pirogov Russian National Research Medical University, Moscow, Russia
Sh.Sh. Éliava
NII neĭrokhirurgii im. akad. N.N. Burdenko RAMN, Moskva
O.B. Belousova
NII neĭrokhirurgii im. akad. N.N. Burdenko RAMN, Moskva
I.A. Savin
Federal State Autonomous Institution «N.N. Burdenko National Medical Research Center for Neurosurgery» of the Ministry of Healthcare of the Russian Federation, Moscow, Russia, 125047, Moscow, 4-th Tverskaya-Yamskaya str.,16, Russia
D.N. Okishev
NII neĭrokhirurgii im. akad. N.N. Burdenko RAMN, Moskva
K.G. Mikeladze
Burdenko’ National medical research center of neurosurgery, Moscow, Russia
O.D. Shekhtman
FGBU "NII neĭrokhirurgii im. akad. N.N. Burdenko" RAMN, Moskva
A.S. Kheĭreddin
NII neĭrokhirurgii im. akad. N.N. Burdenko RAMN, Moskva
An.N. Konovalov
Burdenko Neurosurgical Institute, Moscow, Russia
V.A. Gorozhanin
Burdenko Neurosurgical Institute, Moscow, Russia
A.M. Spiru
Burdenko Neurosurgical Center, Moscow, Russia
N.V. Kurdyumova
Federal State Autonomous Institution «N.N. Burdenko National Medical Research Center for Neurosurgery» of the Ministry of Healthcare of the Russian Federation, Moscow, Russia, 125047, Moscow, 4-th Tverskaya-Yamskaya str.,16, Russia
T.F. Tabasaranskiĭ
FGBU "NII neĭrokhirurgii im. N.N. Burdenko" RAMN, Moskva
A.I. Baranich
Burdenko Neurosurgery Institute, 4-ya Tverskaya-Yamskaya Str., 16, Moscow, Russia, 125047
E.V. Vinogradov
Burdenko’ National medical research center of neurosurgery, Moscow, Russia
Journal: Burdenko's Journal of Neurosurgery. 2019;83(4): 18–33
Intracisternal administration of verapamil for the prevention and treatment of vasospasm in patients after microsurgical treatment of cerebral aneurysms in the acute period of hemorrhage
Authors:
Iu.V. Pilipenko, M.D. Varyukhina, Sh.Sh. Éliava, O.B. Belousova, I.A. Savin, D.N. Okishev, K.G. Mikeladze, O.D. Shekhtman, A.S. Kheĭreddin, An.N. Konovalov, V.A. Gorozhanin, A.M. Spiru, N.V. Kurdyumova, T.F. Tabasaranskiĭ, A.I. Baranich, E.V. Vinogradov
More about the authors
Views : 4515
Downloaded : 56
Open to cite this article
Pilipenko IuV, Varyukhina MD, Éliava ShSh, Belousova OB, Savin IA, Okishev DN, Mikeladze KG, Shekhtman OD, Kheĭreddin AS, Konovalov AnN, Gorozhanin VA, Spiru AM, Kurdyumova NV, Tabasaranskiĭ TF, Baranich AI, Vinogradov EV. Intracisternal administration of verapamil for the prevention and treatment of vasospasm in patients after microsurgical treatment of cerebral aneurysms in the acute period of hemorrhage. Burdenko's Journal of Neurosurgery.
2019;83(4):18‑33.
(In Russ., In Engl.).
https://doi.org/10.17116/neiro20198304118
The first results of intracisternal administration of verapamil for the prevention and treatment of cerebral vasospasm (CVS) in patients in the acute period of subarachnoid hemorrhage (SAH) after microsurgical clipping of cerebral aneurysms are presented. Objective — safety assessment of the method of prolonged intracisternal infusion (PII) of verapamil. Material and methods. Over the period from May 2017 to December 2018, 42 patients were included in the study, who underwent clipping of aneurysm of the anterior segments of the Willis circle. Most patients (78.6%) were operated during the first 6 days after SAH. For each patient, a thin silicone catheter was installed, through which verapamil was infused. A prerequisite was the installation of external ventricular drainage and opening of the lamina terminalis. The daily dosage of verapamil varied from 25 to 50 mg of the drug diluted in 200—400 ml of isotonic sodium chloride solution. The indication for the use of the PII method was the presence of one of the following factors: a score on the Hunt—Hess scale from III to V, 3 or 4 points on the Fisher scale, confirmed angiographically by the CVS before the operation. Results. The PII procedure was performed from 2 to 5 days. The average dose of verapamil was 143.5±41.2 mg additionally, in the presence of an angiographically confirmed CVS accompanied by clinical manifestations, 14 (33.4%) patients received intra-arterial injection of verapamil in several stages, with individual selection of the drug dose. The formation of new cerebral ischemic foci of vasospastic genesis was observed in only 1 (2.4%) patient. No infectious intracranial complications were noted. The average follow-up period was 297.6±156.1 days. Long-term treatment outcomes, assessed by a modified Rankin scale from 0 to 2 points, were observed in 83.3% of patients. There were no outcomes such as vegetative status and no deaths. The frequency of liquorodynamic disorders, as well as epileptic syndrome did not exceed that among patients with SAH according to the literature. Conclusion. The study has confirmed the safety of prolonged PII. The efficacy of the method, compared with other methods for CVS treatment requires further investigation. The first results look quite promising: the observation shows a low percentage of new foci of cerebral ischemia and the absence of deaths associated with it. In patients with severe CVS, the efficacy of the PII method is increased when combined with intra-arterial administration of verapamil.
Authors:
Iu.V. Pilipenko
FGBU "NII neĭrokhirurgii im. akad. N.N. Burdenko" RAMN, Moskva
M.D. Varyukhina
Pirogov Russian National Research Medical University, Moscow, Russia
Sh.Sh. Éliava
NII neĭrokhirurgii im. akad. N.N. Burdenko RAMN, Moskva
O.B. Belousova
NII neĭrokhirurgii im. akad. N.N. Burdenko RAMN, Moskva
I.A. Savin
Federal State Autonomous Institution «N.N. Burdenko National Medical Research Center for Neurosurgery» of the Ministry of Healthcare of the Russian Federation, Moscow, Russia, 125047, Moscow, 4-th Tverskaya-Yamskaya str.,16, Russia
D.N. Okishev
NII neĭrokhirurgii im. akad. N.N. Burdenko RAMN, Moskva
K.G. Mikeladze
Burdenko’ National medical research center of neurosurgery, Moscow, Russia
O.D. Shekhtman
FGBU "NII neĭrokhirurgii im. akad. N.N. Burdenko" RAMN, Moskva
A.S. Kheĭreddin
NII neĭrokhirurgii im. akad. N.N. Burdenko RAMN, Moskva
An.N. Konovalov
Burdenko Neurosurgical Institute, Moscow, Russia
V.A. Gorozhanin
Burdenko Neurosurgical Institute, Moscow, Russia
A.M. Spiru
Burdenko Neurosurgical Center, Moscow, Russia
N.V. Kurdyumova
Federal State Autonomous Institution «N.N. Burdenko National Medical Research Center for Neurosurgery» of the Ministry of Healthcare of the Russian Federation, Moscow, Russia, 125047, Moscow, 4-th Tverskaya-Yamskaya str.,16, Russia
T.F. Tabasaranskiĭ
FGBU "NII neĭrokhirurgii im. N.N. Burdenko" RAMN, Moskva
A.I. Baranich
Burdenko Neurosurgery Institute, 4-ya Tverskaya-Yamskaya Str., 16, Moscow, Russia, 125047
E.V. Vinogradov
Burdenko’ National medical research center of neurosurgery, Moscow, Russia
List of references:
Close metadata
Email Confirmation
An email was sent to test@gmail.com with a confirmation link. Follow the link from the letter to complete the registration on the site.
Email Confirmation
Log in to the site using your account in one of the services
We use cооkies to improve the performance of the site. By staying on our site, you agree to the terms of use of cооkies. To view our Privacy and Cookie Policy, please. click here.