Endovascular therapy for aneurysmal vasospasm

Endovascular treatment of cerebral vasospasm induced by subarachnoid hemorr hage has become a useful therapy. The two main treatments that have been us ed are balloon angioplasty and int ra-arterial papaverine infusion. both tr eatments have been shown to reverse subarachnoid hemorrhage-induced vascula r spasm, increase cerebral blood flow and improve delayed ischemic neurolog ic deficits induced by vasospasm. Balloon angioplasty is superior to papave rine for treatment of proximal vessel vasospasm by virtue of a more sustain ed effect on the vessels. Papaverine can be useful as an adjunct to balloon angioplasty and also for the treatment of distal vessels that are not acce ssible for balloon angioplasty.