Partial aortic obstruction improves cerebral perfusion and clinical symptoms in patients with symptomatic vasospasm

Neurol Res. 2005:27 Suppl 1:S129-35. doi: 10.1179/016164105X35512.

Abstract

Objective: Stroke studies in animals showed that aortic obstruction increases cerebral blood flow (CBF) and reduces infarct size. In this study we evaluate the safety and efficacy of a device providing partial and transitory aortic obstruction.

Methods: We report the results in 24 selected patients with symptomatic vasospasm by aneurysmal subarachnoid hemorrhage treated by partial and transitory aortic obstruction with a novel device (NeuroFlo, CoAxia, MN). Aneurysms were secured by coils prior to the procedure. We studied the adverse effects related to the aorta-obstructing device, and changes in CBF and neurological outcome.

Results: Mean flow velocity increased in both middle cerebral arteries over 15%, and the score in the National Institute of Health Stroke Scale decreased >or=2 point in 20 patients (83%). During the procedure, three patients developed symptoms that were controlled. At 30 days follow-up, three patients had 6 points (unrelated death), three had 3 points, six had 1 point, and 12 had 0 points, in the modified Rankin scale.

Discussion: Partial aortic obstruction was safe, the cerebral blood flow increased without inducing significant hypertension and the neurological defects improved in most of the patients. Efficacy with a better level of evidence will be determined by a randomized study.

MeSH terms

  • Adult
  • Arterial Occlusive Diseases / physiopathology*
  • Arterial Occlusive Diseases / therapy*
  • Blood Pressure
  • Cerebrovascular Circulation*
  • Female
  • Humans
  • Middle Aged
  • Patient Selection
  • Vasospasm, Intracranial / etiology*