Treatment of cerebral vasospasm secondary to subarachnoid hemorrhage utilizing the Comaneci device

Interv Neuroradiol. 2020 Oct;26(5):582-585. doi: 10.1177/1591019920945554. Epub 2020 Jul 28.

Abstract

Delayed cerebral ischemia due to vasospasm following subarachnoid hemorrhage continues to have high morbidity and mortality despite current treatments. This report highlights the use of the Comaneci (Rapid Medical, Yokneam, Israel), a device FDA approved for temporary coil embolization assistance, for the treatment of symptomatic vasospasm. Ten days post subarachnoid hemorrhage, a patient developed acute left-sided hemiparesis with angiographic vasospasm. Through a Headway 17 microcatheter, a Comaneci 17 was deployed in the right ICA terminus, M1, M2, A1, and, A2 segments resulting in improvement of angiographic vasospasm and the patient's left-sided hemiparesis. On the following day, a repeat angiogram demonstrated no recurrence of vasospasm. The patient had complete return on neurologic function by post bleed day 18 continuing to her four-week follow-up appointment. This case demonstrates the feasibility of the Comaneci device as an effective tool in the treatment of vasospasm following subarachnoid hemorrhage.

Keywords: Subarachnoid; angioplasty; hemorrhage; stent; stroke.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Cerebral Angiography
  • Computed Tomography Angiography
  • Embolization, Therapeutic / instrumentation*
  • Female
  • Humans
  • Magnetic Resonance Imaging
  • Subarachnoid Hemorrhage / complications*
  • Subarachnoid Hemorrhage / diagnostic imaging
  • Vasospasm, Intracranial / diagnostic imaging
  • Vasospasm, Intracranial / etiology*
  • Vasospasm, Intracranial / therapy*