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<meta name="DC.Title" content="Intraarterially Administered Verapamil as Adjunct Therapy for Cerebral Vasospasm: Safety and 2-Year Experience" />
<meta name="DC.Date" content="2002-09-01" />
<meta name="DC.Publisher" content="American Journal of Neuroradiology" />
<meta name="DC.Rights" content="Copyright © American Society of Neuroradiology" />
<meta name="DC.AccessRights" content="restricted" />
<meta name="DC.Description" content="BACKGROUND AND PURPOSE: Despite the widespread use of angioplasty, adjunct chemical therapy is often needed to treat patients with cerebral vasospasm. In this study, we examined the safety of intraarterial administration of verapamil to patients with cerebral vasospasm. We herein summarize our 2-year experience with this treatment.

METHODS: We retrospectively reviewed the procedure reports, anesthesia records, clinical charts, and brain images of 29 patients who received intraarterially administered verapamil in 34 procedures for the treatment of vasospasm after subarachnoid hemorrhage from July 1998 to June 2000. The average changes in mean arterial pressure and heart rate were used to measure cardiovascular side effects. The neurologic effects were assessed by angiographic findings, the results of neurologic examinations performed before and after the procedure, and findings of CT of the head.

RESULTS: The average dose of verapamil per patient was 3 ± 0 mg or 44 ± 5 mcg/kg. The average changes in mean arterial pressure at 10 and 20 minutes were −5 ± 1 mm Hg and −2 ± 1 mm Hg or −3.8 ± 1.0% and −1.7 ± 1.1%, respectively. No significant change of heart rate was observed at 10 minutes. The patients showed no sign of increased intracranial pressure by hemodynamic parameters, neurologic examination, or CT of the head. On 10 occasions, when the effect of verapamil infusion was assessed angiographically, there was 44 ± 9% increase of vessel diameter in the spastic segment. Neurologic improvement was noted after five of 17 procedures when verapamil was used as the sole treatment.

CONCLUSION: Low dose verapamil is safe when administered intraarterially to patients with cerebral vasospasm. Beneficial effects are achieved in some patients, prompting further study of its efficacy." />
<meta name="DC.Contributor" content="Lei Feng" />
<meta name="DC.Contributor" content="Brian-Fred Fitzsimmons" />
<meta name="DC.Contributor" content="William L. Young" />
<meta name="DC.Contributor" content="Mitchell F. Berman" />
<meta name="DC.Contributor" content="Erwin Lin" />
<meta name="DC.Contributor" content="Beverly D. L. Aagaard" />
<meta name="DC.Contributor" content="Hoang Duong" />
<meta name="DC.Contributor" content="John Pile-Spellman" />
<meta name="article:published_time" content="2002-09-01" />
<meta name="article:section" content="INTERVENTIONAL" />
<meta name="citation_title" content="Intraarterially Administered Verapamil as Adjunct Therapy for Cerebral Vasospasm: Safety and 2-Year Experience" />
<meta name="citation_abstract" lang="en" content="&lt;p&gt;&lt;i&gt;BACKGROUND AND PURPOSE:&lt;/i&gt; Despite the widespread use of angioplasty, adjunct chemical therapy is often needed to treat patients with cerebral vasospasm. In this study, we examined the safety of intraarterial administration of verapamil to patients with cerebral vasospasm. We herein summarize our 2-year experience with this treatment.&lt;/p&gt;&lt;p&gt;&lt;i&gt;METHODS:&lt;/i&gt; We retrospectively reviewed the procedure reports, anesthesia records, clinical charts, and brain images of 29 patients who received intraarterially administered verapamil in 34 procedures for the treatment of vasospasm after subarachnoid hemorrhage from July 1998 to June 2000. The average changes in mean arterial pressure and heart rate were used to measure cardiovascular side effects. The neurologic effects were assessed by angiographic findings, the results of neurologic examinations performed before and after the procedure, and findings of CT of the head.&lt;/p&gt;&lt;p&gt;&lt;i&gt;RESULTS:&lt;/i&gt; The average dose of verapamil per patient was 3 ± 0 mg or 44 ± 5 mcg/kg. The average changes in mean arterial pressure at 10 and 20 minutes were −5 ± 1 mm Hg and −2 ± 1 mm Hg or −3.8 ± 1.0% and −1.7 ± 1.1%, respectively. No significant change of heart rate was observed at 10 minutes. The patients showed no sign of increased intracranial pressure by hemodynamic parameters, neurologic examination, or CT of the head. On 10 occasions, when the effect of verapamil infusion was assessed angiographically, there was 44 ± 9% increase of vessel diameter in the spastic segment. Neurologic improvement was noted after five of 17 procedures when verapamil was used as the sole treatment.&lt;/p&gt;&lt;p&gt;&lt;i&gt;CONCLUSION:&lt;/i&gt; Low dose verapamil is safe when administered intraarterially to patients with cerebral vasospasm. Beneficial effects are achieved in some patients, prompting further study of its efficacy.&lt;/p&gt;" />
<meta name="citation_journal_title" content="American Journal of Neuroradiology" />
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<meta name="citation_author" content="Lei Feng" />
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<meta name="twitter:title" content="Intraarterially Administered Verapamil as Adjunct Therapy for Cerebral Vasospasm: Safety and 2-Year Experience" />
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<meta name="twitter:description" content="BACKGROUND AND PURPOSE: Despite the widespread use of angioplasty, adjunct chemical therapy is often needed to treat patients with cerebral vasospasm. In this study, we examined the safety of intraarterial administration of verapamil to patients with cerebral vasospasm. We herein summarize our 2-year experience with this treatment.

METHODS: We retrospectively reviewed the procedure reports, anesthesia records, clinical charts, and brain images of 29 patients who received intraarterially administered verapamil in 34 procedures for the treatment of vasospasm after subarachnoid hemorrhage from July 1998 to June 2000. The average changes in mean arterial pressure and heart rate were used to measure cardiovascular side effects. The neurologic effects were assessed by angiographic findings, the results of neurologic examinations performed before and after the procedure, and findings of CT of the head.

RESULTS: The average dose of verapamil per patient was 3 ± 0 mg or 44 ± 5 mcg/kg. The average changes in mean arterial pressure at 10 and 20 minutes were −5 ± 1 mm Hg and −2 ± 1 mm Hg or −3.8 ± 1.0% and −1.7 ± 1.1%, respectively. No significant change of heart rate was observed at 10 minutes. The patients showed no sign of increased intracranial pressure by hemodynamic parameters, neurologic examination, or CT of the head. On 10 occasions, when the effect of verapamil infusion was assessed angiographically, there was 44 ± 9% increase of vessel diameter in the spastic segment. Neurologic improvement was noted after five of 17 procedures when verapamil was used as the sole treatment.

CONCLUSION: Low dose verapamil is safe when administered intraarterially to patients with cerebral vasospasm. Beneficial effects are achieved in some patients, prompting further study of its efficacy." />
<meta name="og-title" property="og:title" content="Intraarterially Administered Verapamil as Adjunct Therapy for Cerebral Vasospasm: Safety and 2-Year Experience" />
<meta name="og-url" property="og:url" content="http://ajnr-stage2.stage.highwire.org/content/23/8/1284" />
<meta name="og-site-name" property="og:site_name" content="American Journal of Neuroradiology" />
<meta name="og-description" property="og:description" content="BACKGROUND AND PURPOSE: Despite the widespread use of angioplasty, adjunct chemical therapy is often needed to treat patients with cerebral vasospasm. In this study, we examined the safety of intraarterial administration of verapamil to patients with cerebral vasospasm. We herein summarize our 2-year experience with this treatment.

METHODS: We retrospectively reviewed the procedure reports, anesthesia records, clinical charts, and brain images of 29 patients who received intraarterially administered verapamil in 34 procedures for the treatment of vasospasm after subarachnoid hemorrhage from July 1998 to June 2000. The average changes in mean arterial pressure and heart rate were used to measure cardiovascular side effects. The neurologic effects were assessed by angiographic findings, the results of neurologic examinations performed before and after the procedure, and findings of CT of the head.

RESULTS: The average dose of verapamil per patient was 3 ± 0 mg or 44 ± 5 mcg/kg. The average changes in mean arterial pressure at 10 and 20 minutes were −5 ± 1 mm Hg and −2 ± 1 mm Hg or −3.8 ± 1.0% and −1.7 ± 1.1%, respectively. No significant change of heart rate was observed at 10 minutes. The patients showed no sign of increased intracranial pressure by hemodynamic parameters, neurologic examination, or CT of the head. On 10 occasions, when the effect of verapamil infusion was assessed angiographically, there was 44 ± 9% increase of vessel diameter in the spastic segment. Neurologic improvement was noted after five of 17 procedures when verapamil was used as the sole treatment.

CONCLUSION: Low dose verapamil is safe when administered intraarterially to patients with cerebral vasospasm. Beneficial effects are achieved in some patients, prompting further study of its efficacy." />
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      <h1 class="highwire-cite-title" id="page-title">Intraarterially Administered Verapamil as Adjunct Therapy for Cerebral Vasospasm: Safety and 2-Year Experience</h1>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0">Lei Feng</span>, <span class="highwire-citation-author" data-delta="1">Brian-Fred Fitzsimmons</span>, <span class="highwire-citation-author" data-delta="2">William L. Young</span>, <span class="highwire-citation-author" data-delta="3">Mitchell F. Berman</span>, <span class="highwire-citation-author" data-delta="4">Erwin Lin</span>, <span class="highwire-citation-author" data-delta="5">Beverly D. L. Aagaard</span>, <span class="highwire-citation-author" data-delta="6">Hoang Duong</span> and <span class="highwire-citation-author" data-delta="7">John Pile-Spellman</span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">September 2002,  </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">23 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(8) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">1284-1290; </span></div>
  
  
  
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<div id="hw-article-author-popups-top-node-10210--6396977532" style="display: none;"><div class="author-tooltip-0"><div class="author-tooltip-name">Lei Feng </div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=Lei%2BFeng%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Feng%20L&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3ALei%2BFeng%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-1"><div class="author-tooltip-name">Brian-Fred Fitzsimmons </div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=Brian-Fred%2BFitzsimmons%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Fitzsimmons%20B&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3ABrian-Fred%2BFitzsimmons%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-2"><div class="author-tooltip-name">William L. 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