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Consult this case by Vladimir Kalousek of a 77-year-old male patient with clinical and radiological findings of diffuse SA.
The case is about a 77-year-old male patient who came to a hospital with clinical and radiological findings of diffuse SA.
A CT angio and DSA was performed but were negative.
During the time in the neurological ICU, higher speeds on TCD were noticed which were suggesting the development of vasospasm in both anterior cerebral arteries, as well as clinical deterioration.
The patient was prepared for the procedure.
Fubuki 7f catheter was placed first into right ACI, then into left. There was a noticeable narrowing of the A1 segment was present.
Comaneci device 17 was brought into the a1 segment of the left side and slowly opened while injecting IA through guiding catheter Nimotop.
Control angiograms showed resolution of vasospasm and better distal filling.
After few days, recurrence of vasospasm was noticed on TCD. The patient was brought to angio again and this time NeVa VS device was used as well as tigertriver, as well as injection of Nimotop through guiding catheter while stentretrievers are opened.
NeVa VS is part of the NeVa product range Vesalio used in thrombectomy, as well as the TigerTriever for Rapid Medical.
NeVa VS is a version of the NeVa product range that is less specific.
It does not have the signature drop zones and has more evenly distributed and strong expansive radial force along the product length, so we decided to try it to resolve this vasospasm case.
On the other hand, both Tigertriever and Comaneci device Rapid Medical, have handled, so You can control the expansion of the device by Your hand, and even more, they have a version which goes through 0.17 micro, which seems suitable for narrower vessels and to have a more tactile feel of expanding the vessels.
