{
  "abstract": "Introduction Refractory cerebral vasospasm (CV) and delayed cerebral ischemia (DCI) following aneurysmal subarachnoid hemorrhage (aSAH) are associated with high morbidity and mortality; CV may recur despite intra-arterial chemical treatment, and the role of adjunctive mechanical angioplasty remains unclear.Aim of Study The objective of this pilot randomized prospective trial was to assess the effects of the adjunction of mechanical angioplasty to chemical vasodilation alone on the reduction of brain hypoperfusion.Method In a prospective, monocentric, interventional trial, we randomly assigned patients with a refractory CV within the internal carotid arteries (ICAs) and an indication for endovascular management to undergo intra-arterial chemical angioplasty (control group) or chemical plus mechanical angioplasty (treatment group). The primary end point was the change of brain perfusion in the dedicated arterial territory measured by the Time to Drain (TTD) on CT perfusion.Abstract A16 Figure 1Results A total of 12 patients with 44 refractory CV were randomly assigned, 21/44 (55 arterial segments) to the intervention group and 23/44 (86 arterial segments) to the control group. Median change in TTD beyond the treated artery was of -43% (-62- -34) in the intervention group (β, -20; 95% confidence interval [CI], -27 to -13; P<0.001) versus -10% (-49–9). Median change in vessel size was of 83% in the intervention group as compared with 27% in the control group (P<0.001).Conclusion In this pilot randomized study, among SAH patients with refractory vasospasm in the ICA requiring endovascular management, the adjunction of mechanical angioplasty was associated with a significantly higher improvement in brain perfusion and a lower risk of recurrence.Conflict of Interest No",
  "authors": [
    {
      "affiliations": [
        "Erasme Hospital, Brussels, Belgium"
      ],
      "name": "Adrien Guenego"
    },
    {
      "affiliations": [
        "Erasme Hospital, Brussels, Belgium"
      ],
      "name": "Boris Lubicz"
    }
  ],
  "title": "A16 Chemical versus chemical and mechanical angioplasty for cerebral vasospasm after aneurysmal hemorrhage: a pilot randomized study",
  "uid": "434a0d91-dc73-5fb1-a723-7d0f812137c8"
}