Intraarterially Administered Verapamil as Adjunct Therapy for Cerebral Vasospasm: Safety and 2-Year Experience
Lei Fenga,
Brian-Fred Fitzsimmonsb,
William L. Youngc,
Mitchell F. Bermanc,
Erwin Lina,
Beverly D. L. Aagaarda,
Hoang Duonga and
John Pile-Spellmana,d
a Department of Radiology, College of Physicians & Surgeons, Columbia University, New York, NY
b Department of Neurology, College of Physicians & Surgeons, Columbia University, New York, NY
c Department of Anesthesiology, College of Physicians & Surgeons, Columbia University, New York, NY
d Department of Neurosurgery, College of Physicians & Surgeons, Columbia University, New York, NY
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FIG 1. Frontal projection angiograms of the right internal carotid artery.
A, Before treatment with verapamil. Before verapamil infusion, moderately severe vasospasm can be seen in the right anterior cerebral, middle cerebral, and distal internal carotid arteries. Better and more rapid opacification of the right posterior cerebral artery through the right posterior communicating artery can be seen, suggesting high resistance in the anterior circulation.
B, After treatment with verapamil. The diameters of the right distal internal carotid artery, right M1 section, and right A1 section increase by 6%, 12%, and 68%, respectively. Normal opacification of the right middle and anterior cerebral arteries is restored, even though there is no significant change of the diameters of the distal internal carotid and right middle cerebral arteries.
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