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  • Use of hyperform balloon as a flow related balloon during angioplasty without a guide wire in treating clinical vasospasm due to aneurysmal subarachnoid hemorrhage.

    Final Number:

    Parthasarathi Chamiraju MD; David Newell MD; Stephen Monteith MD; Joe Eskridge MD

    Study Design:

    Subject Category:

    Meeting: AANS/CNS Cerebrovascular Section 2014 Annual Meeting

    Introduction: Cerebral vasospasm after aneurysmal subarachnoid hemorrhage is one of the difficult complications to treat. Balloon angioplasty for cerebral vasospasm is performed by using compliant balloons like Hyperform (EV3) or Hyperglide (EV3) with a guide wire.

    Methods: All patients who underwent balloon angioplasty for treating vasospasm of aneurysmal subarachnoid hemorrhage during September 2010- August 2013 were included in the study. Out of 62 patients who had endovascular treatment for vasospasm, 41 patients were treated by balloon angioplasty in 54 vessel segment. Twenty two patients required more than one angioplasty for clinical response. Patients were followed till they are discharged from the hospital. Eight patients had no clinical improvement even after multiple angioplasties. Morbidity is defined as symptomatic hydrocephalus or an infarct or a residual or new neurological deficit. In all patients the balloon was used as a flow related rather than pressure related by removing the guide wire after passing the affected segment.

    Results: Out of 41 patients, good clinical response was seen in 19 patients after first angioplasty. Sixteen patients required two angioplasties for a clinical response. Eight patients did not respond to multiple angioplasties and developed infarct in the corresponding territory. There were 5 deaths in the series. None of the patients developed complications directly related to the use of flow related balloon for angioplasty.

    Conclusions: Balloon angioplasty for treating cerebral vasospasm of aneurysmal SAH by using Hyperform balloon (EV3)as a flow related balloon (with out using a guide wire) is a safe and efficient technique.

    Patient Care: Using the Hyperform balloon during angioplasty as a flow related balloon in treating vasospasm is a safe and efficient technique. This is regularly used in our institute which is quick and equally safe.

    Learning Objectives: Using the Hyperform balloon during angioplasty as a flow related balloon in treating vasospasm is a safe and efficient technique.


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