gms | German Medical Science

66. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Friendship Meeting mit der Italienischen Gesellschaft für Neurochirurgie (SINch)

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

7. - 10. Juni 2015, Karlsruhe

Intraarterial and systemic application of Milrinone in the treatment of severe vasospasm caused by SAH

Meeting Abstract

  • Richard Brucker - Neurochirurgische Klinik
  • Patrick Gebetsroither - Neurochirurgische Klinik
  • Dirk Vorwerk - Institut für diagnostische und interventionelle Radiologie, Klinikum Ingolstadt
  • Siamak Asgari - Neurochirurgische Klinik

Deutsche Gesellschaft für Neurochirurgie. 66. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC). Karlsruhe, 07.-10.06.2015. Düsseldorf: German Medical Science GMS Publishing House; 2015. DocMI.14.09

doi: 10.3205/15dgnc351, urn:nbn:de:0183-15dgnc3518

Veröffentlicht: 2. Juni 2015

© 2015 Brucker et al.
Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). Lizenz-Angaben siehe http://creativecommons.org/licenses/by/4.0/.


Gliederung

Text

Objective: The treatment of DIND is one of the most important tasks to reduce the mortality and morbidity of aneurismal SAH. The aim of this retrospective study was to observe the efficacy and safety of intra-arterial and systemic application of the Phosphodiesterase-3-inhibitor Milrinone in the treatment of severe vasospasm.

Method: 12 patients with severe vasospasm after a ruptured intracranial aneurysm were treated with intra-arterial and systemic application of Milrinone during the last 11 months. In these patients, standard therapy with Nimodipine and medical intensive care support was not able to avoid severe and symptomatic cerebral vasospasm. Cerebral angiography demonstrated reduction of arterial diameter of more than 40 % in one or more arterial segments in all patients. Intra-arterial Milrinone was given on each of three following days and systemic intravenous application of Milrinone for the next 14 days. Repeated cerebral angiography was performed in the acute stage, neurological examination after 6 weeks, and the side-effects of the dual Milrinone therapy were observed.

Results: In each patient, cerebral angiography revealed enlargement of the vasospastic arterial segment. Most of the patients showed a moderate or good neurological outcome at the six-week-examination. The GOS ranged between 2 and 5. No side-effects of Milrinone were observed.

Conclusions: The dual application (intra-arterial and intravenous) of Milrinone is a safe and effective therapy in severe cerebral vasospasm after aneurismal SAH, but cannot avoid worse neurological outcome in every patient. This study led to preliminary results, which have to be evaluated by further investigations.