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Intra-aortic balloon counterpulsation: augmentation of cerebral blood flow after aneurysmal subarachnoid haemorrhage

Intra-aortic balloon counterpulsation: augmentation of cerebral blood flow after aneurysmal subarachnoid haemorrhage
Intra-aortic balloon counterpulsation: augmentation of cerebral blood flow after aneurysmal subarachnoid haemorrhage

OBJECTIVE: To measure cerebral blood flow before and after intra-aortic balloon counterpulsation (IABC) in patients at high risk of developing delayed cerebral ischaemia after aneurysm surgery following subarachnoid haemorrhage.

METHODS: Six prospectively selected patients at high risk of developing delayed ischaemia had elective IABC after clipping of their cerebral aneurysm(s). The IAB inflates in early diastole and deflates at the end of diastole to increase cardiac perfusion and decrease afterload. This results in enhanced cardiac efficiency. It also augments cerebral blood flow (CBF).

RESULTS: We demonstrated a significant increase in the mean hemispheric CBF from the preoperative (preIABC) value of 35.6 mls/100 g/min to 50.9 +/- 12.3 mls/100 g/min (p = 0.0042) as a result of balloon augmentation. Each patient developed a neurological deficit as a result of delayed cerebral ischaemia. These were reversed in 5 patients with increased CBF. There were minimal balloon related complications.

CONCLUSION: IABC consistently enhanced CBF in these patients and resulted in stable cardiovascular parameters. This represents a possible new technique in the management of cerebral ischaemia following subarachnoid haemorrhage and needs further assessment to ascertainlits role.

Adult, Aged, Brain, Brain Ischemia, Female, Humans, Intra-Aortic Balloon Pumping, Intracranial Aneurysm, Male, Middle Aged, Prospective Studies, Regional Blood Flow, Risk Factors, Subarachnoid Hemorrhage, Journal Article
0001-6268
115-123
Spann, R.G.
f2e1fea0-6ab2-4d94-9bb8-2bbc914aa2c7
Lang, D.A.
e2b78b90-6496-488a-87cd-91b74c739447
Birch, A.A.
755f2236-4c0c-49b5-9884-de4021acd42d
Lamb, R.
e4cb6d5e-9ec9-45b9-ab91-5506e0401e23
Neil-Dwyer, G.
19520fec-ecd3-436f-9420-b7bd776751c3
Spann, R.G.
f2e1fea0-6ab2-4d94-9bb8-2bbc914aa2c7
Lang, D.A.
e2b78b90-6496-488a-87cd-91b74c739447
Birch, A.A.
755f2236-4c0c-49b5-9884-de4021acd42d
Lamb, R.
e4cb6d5e-9ec9-45b9-ab91-5506e0401e23
Neil-Dwyer, G.
19520fec-ecd3-436f-9420-b7bd776751c3

Spann, R.G., Lang, D.A., Birch, A.A., Lamb, R. and Neil-Dwyer, G. (2001) Intra-aortic balloon counterpulsation: augmentation of cerebral blood flow after aneurysmal subarachnoid haemorrhage. Acta Neurochirurgica, 143 (2), 115-123.

Record type: Article

Abstract

OBJECTIVE: To measure cerebral blood flow before and after intra-aortic balloon counterpulsation (IABC) in patients at high risk of developing delayed cerebral ischaemia after aneurysm surgery following subarachnoid haemorrhage.

METHODS: Six prospectively selected patients at high risk of developing delayed ischaemia had elective IABC after clipping of their cerebral aneurysm(s). The IAB inflates in early diastole and deflates at the end of diastole to increase cardiac perfusion and decrease afterload. This results in enhanced cardiac efficiency. It also augments cerebral blood flow (CBF).

RESULTS: We demonstrated a significant increase in the mean hemispheric CBF from the preoperative (preIABC) value of 35.6 mls/100 g/min to 50.9 +/- 12.3 mls/100 g/min (p = 0.0042) as a result of balloon augmentation. Each patient developed a neurological deficit as a result of delayed cerebral ischaemia. These were reversed in 5 patients with increased CBF. There were minimal balloon related complications.

CONCLUSION: IABC consistently enhanced CBF in these patients and resulted in stable cardiovascular parameters. This represents a possible new technique in the management of cerebral ischaemia following subarachnoid haemorrhage and needs further assessment to ascertainlits role.

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More information

Published date: 2001
Keywords: Adult, Aged, Brain, Brain Ischemia, Female, Humans, Intra-Aortic Balloon Pumping, Intracranial Aneurysm, Male, Middle Aged, Prospective Studies, Regional Blood Flow, Risk Factors, Subarachnoid Hemorrhage, Journal Article

Identifiers

Local EPrints ID: 427682
URI: http://eprints.soton.ac.uk/id/eprint/427682
ISSN: 0001-6268
PURE UUID: 818d74fd-3989-411c-a9e0-bfa8cdbbe7f5
ORCID for A.A. Birch: ORCID iD orcid.org/0000-0002-2328-702X

Catalogue record

Date deposited: 25 Jan 2019 17:30
Last modified: 20 Jul 2019 00:23

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Contributors

Author: R.G. Spann
Author: D.A. Lang
Author: A.A. Birch ORCID iD
Author: R. Lamb
Author: G. Neil-Dwyer

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