{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T22:34:07Z","timestamp":1780526047202,"version":"3.54.1"},"reference-count":19,"publisher":"Springer Science and Business Media LLC","issue":"4","license":[{"start":{"date-parts":[[2026,2,16]],"date-time":"2026-02-16T00:00:00Z","timestamp":1771200000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,2,16]],"date-time":"2026-02-16T00:00:00Z","timestamp":1771200000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Universit\u00e4tsklinikum Augsburg"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Cardiovasc Intervent Radiol"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To compare differences in efficacy of endovascular vasospasm therapy (EVT) with pharmacological, mechanical or combined treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In a single-center retrospective analysis, we included 60 patients with EVT after aneurysmal subarachnoid hemorrhage from 2017\u20132022. EVT treatment groups were: 1. Single or 2. dual vasodilator application, 3. transluminal balloon angioplasty (TBA) alone, with 4. single, or 5. dual vasodilator application, or 6. Stent-Retriever-Angioplasty alone, with 7. single, or 8. dual vasodilator application. Arterial diameters were measured on admission and after treatment. We compared relative increase and significant difference in diameter for each treatment group via multivariable linear regression (SPSS statistics). Age, sex, number of previous treatments and severity of spasm were included as confounding variables.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In 628 treated vessel segments, dual vasodilator application showed significant difference restoring 4.4% more diameter than single vasodilator application alone (\n                      <jats:italic>p<\/jats:italic>\n                      \u2014.015). TBA alone, with single or dual vasodilator application was most effective, restoring 28.4% more diameter than single vasodilator application alone (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u2009.001). Stent-Retriever-Angioplasty was more effective with combined dual vasodilator application (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u2009.001), not with single or no vasodilator combination. Adverse outcomes were recorded in 2.4% of interventions.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>EVT effectiveness remains a key target in vasospasm rescue treatment but relies on the right treatment modality. TBA remains most effective in vessel dilation. Stent-Retriever-Angioplasty may present an alternative to just pharmacological treatment balancing accessibility and risk profile. Using a combination of vasodilators may enhance treatment efficacy but the combination of nimodipine and papaverine shows little effect in our study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Graphical Abstract<\/jats:title>\n                  <\/jats:sec>","DOI":"10.1007\/s00270-026-04367-w","type":"journal-article","created":{"date-parts":[[2026,2,16]],"date-time":"2026-02-16T14:10:18Z","timestamp":1771251018000},"page":"800-808","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Pharmaceutically Assisted Angioplasty to Relieve Cerebral Vasospasm after Aneurysmal Subarachnoid Hemorrhage\u2014A Retrospective, Single-Center, Observational Comparison of Established and New Treatment Techniques"],"prefix":"10.1007","volume":"49","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-1794-6449","authenticated-orcid":false,"given":"C.","family":"Thole","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C. J.","family":"Maurer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Berlis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,2,16]]},"reference":[{"key":"4367_CR1","doi-asserted-by":"publisher","unstructured":"Hoh BL, Ko NU, Amin-Hanjani S, et al. Guideline for the management of patients with aneurysmal subarachnoid hemorrhage: a guideline from the American Heart Association\/American Stroke Association. Stroke. 2023;54(7):e314\u201370. https:\/\/doi.org\/10.1161\/STR.0000000000000436.","DOI":"10.1161\/STR.0000000000000436"},{"key":"4367_CR2","doi-asserted-by":"publisher","first-page":"374","DOI":"10.19224\/ai2023.374","volume":"64","author":"A Prakapenia","year":"2023","unstructured":"Prakapenia A, Koch T, Rand A. Intensivmedizinisches Management der aneurysmatischen Subarachnoidalblutung. Anaesth Intensivmed. 2023;64:374\u201380. https:\/\/doi.org\/10.19224\/ai2023.374.","journal-title":"Anaesth Intensivmed"},{"key":"4367_CR3","doi-asserted-by":"publisher","unstructured":"Guenego A, Fahed R, Rouchaud A, et al. Diagnosis and endovascular management of vasospasm after aneurysmal subarachnoid hemorrhage - survey of real-life practices. J Neurointerv Surg. 2024;16(7):677\u201383. https:\/\/doi.org\/10.1136\/jnis-2023-020544","DOI":"10.1136\/jnis-2023-020544"},{"key":"4367_CR4","doi-asserted-by":"publisher","DOI":"10.1055\/a-2266-3117","author":"A Neumann","year":"2024","unstructured":"Neumann A, Schacht H, Schramm P. Neuroradiologische Diagnostik und Therapie von zerebralen Vasospasmen nach Subarachnoidalblutung. Rofo. 2024. https:\/\/doi.org\/10.1055\/a-2266-3117.","journal-title":"Rofo"},{"key":"4367_CR5","doi-asserted-by":"publisher","DOI":"10.3390\/jcm11164642","volume":"11","author":"A Khanafer","year":"2022","unstructured":"Khanafer A, Bhogal P, Hellstern V, Harmening C, B\u00e4zner H, Ganslandt O, et al. Vasospasm-related death after aneurysmal subarachnoid hemorrhage: a retrospective case\u2013control study. J Clin Med. 2022;11:4642. https:\/\/doi.org\/10.3390\/jcm11164642.","journal-title":"J Clin Med"},{"key":"4367_CR6","doi-asserted-by":"publisher","first-page":"3333","DOI":"10.1007\/s00330-016-4702-y","volume":"27","author":"G Boulouis","year":"2017","unstructured":"Boulouis G, Labeyrie MA, Raymond J, et al. Treatment of cerebral vasospasm following aneurysmal subarachnoid haemorrhage: a systematic review and meta-analysis. Eur Radiol. 2017;27:3333\u201342. https:\/\/doi.org\/10.1007\/s00330-016-4702-y.","journal-title":"Eur Radiol"},{"key":"4367_CR7","doi-asserted-by":"publisher","unstructured":"L\u00f3pez-Rueda A, Vargas A, Pi\u00f1ana C, et al. Angioplasty with a stent retriever to treat vasospasm secondary to subarachnoid hemorrhage due to an aneurysm: a multicenter study of safety and efficacy. Radiologia (Engl Ed). 2022;64(2):103\u201309. https:\/\/doi.org\/10.1016\/j.rxeng.2020.04.009.","DOI":"10.1016\/j.rxeng.2020.04.009"},{"issue":"9","key":"4367_CR8","doi-asserted-by":"publisher","first-page":"864","DOI":"10.1136\/jnis-2022-019272","volume":"15","author":"MM Salem","year":"2023","unstructured":"Salem MM, Khalife J, Desai S, Sharashidze V, Badger C, Kuhn AL, et al. COManeci MechANical Dilation for vasospasm (COMMAND): multicenter experience. J Neurointerv Surg. 2023;15(9):864\u201370. https:\/\/doi.org\/10.1136\/jnis-2022-019272.","journal-title":"J Neurointerv Surg"},{"key":"4367_CR9","doi-asserted-by":"publisher","first-page":"e657","DOI":"10.1016\/j.wneu.2019.12.097","volume":"135","author":"YS Su","year":"2020","unstructured":"Su YS, Ali MS, Pukenas BA, et al. Novel treatment of cerebral vasospasm using Solitaire stent retriever-assisted angioplasty: case series. World Neurosurg. 2020;135:e657\u201363. https:\/\/doi.org\/10.1016\/j.wneu.2019.12.097.","journal-title":"World Neurosurg"},{"key":"4367_CR10","doi-asserted-by":"publisher","DOI":"10.1016\/j.clineuro.2019.105590","volume":"188","author":"H Schacht","year":"2020","unstructured":"Schacht H, K\u00fcchler J, Boppel T, et al. Transluminal balloon angioplasty for cerebral vasospasm after spontaneous subarachnoid hemorrhage: A single-center experience. Clin Neurol Neurosurg. 2020;188:105590. https:\/\/doi.org\/10.1016\/j.clineuro.2019.105590.","journal-title":"Clin Neurol Neurosurg"},{"key":"4367_CR11","doi-asserted-by":"publisher","DOI":"10.3390\/jcm11072011","volume":"11","author":"H Merkel","year":"2022","unstructured":"Merkel H, Lindner D, Gaber K, Ziganshyna S, Jentzsch J, Mucha S, et al. Standardized classification of cerebral vasospasm after subarachnoid hemorrhage by digital subtraction angiography. J Clin Med. 2022;11:2011. https:\/\/doi.org\/10.3390\/jcm11072011.","journal-title":"J Clin Med"},{"issue":"5","key":"4367_CR12","doi-asserted-by":"publisher","first-page":"290","DOI":"10.1016\/j.neurad.2017.12.020","volume":"45","author":"S Afat","year":"2018","unstructured":"Afat S, Brockmann C, Nikoubashman O, et al. Diagnostic performance of different perfusion algorithms for the detection of angiographical spasm. J Neuroradiol. 2018;45(5):290\u20134. https:\/\/doi.org\/10.1016\/j.neurad.2017.12.020.","journal-title":"J Neuroradiol"},{"key":"4367_CR13","doi-asserted-by":"publisher","first-page":"649","DOI":"10.1007\/s00062-024-01402-6","volume":"34","author":"A Khanafer","year":"2024","unstructured":"Khanafer A, von Gottberg P, Albi\u00f1a-Palmarola P, et al. Is Stent Retraction to ReLieve Arterial Cerebral VaSospasm Caused by SAH (Stent-ReLACSS) Using PRELAX the Long-awaited Solution for Treatment of Posthemorrhagic Cerebral Vasospasm? Clin Neuroradiol. 2024;34:649\u201362. https:\/\/doi.org\/10.1007\/s00062-024-01402-6.","journal-title":"Clin Neuroradiol"},{"key":"4367_CR14","doi-asserted-by":"publisher","DOI":"10.1038\/jcbfm.2011.7","author":"N Etminan","year":"2011","unstructured":"Etminan N, Vergouwen MD, Ilodigwe D, Macdonald RL. Effect of pharmaceutical treatment on vasospasm, delayed cerebral ischemia, and clinical outcome in patients with aneurysmal subarachnoid hemorrhage: a systematic review and meta-analysis. J Cereb Blood Flow Metab. 2011. https:\/\/doi.org\/10.1038\/jcbfm.2011.7.","journal-title":"J Cereb Blood Flow Metab"},{"key":"4367_CR15","doi-asserted-by":"publisher","first-page":"751","DOI":"10.1007\/s00062-018-0711-3","volume":"29","author":"HJ Kwon","year":"2019","unstructured":"Kwon HJ, Lim JW, Koh HS, et al. Stent-Retriever Angioplasty for Recurrent Post-Subarachnoid Hemorrhagic Vasospasm \u2013 A Single Center Experience with Long-Term Follow-Up. Clin Neuroradiol. 2019;29:751\u201361. https:\/\/doi.org\/10.1007\/s00062-018-0711-3.","journal-title":"Clin Neuroradiol"},{"key":"4367_CR16","doi-asserted-by":"publisher","DOI":"10.3174\/ajnr.A8617","author":"J Cortese","year":"2025","unstructured":"Cortese J, Bayraktar EA, Ghozy S, et al. Stent angioplasty for the treatment of cerebral vasospasm: a systematic review and meta-analysis. AJNR Am J Neuroradiol. 2025. https:\/\/doi.org\/10.3174\/ajnr.A8617.","journal-title":"AJNR Am J Neuroradiol"},{"key":"4367_CR17","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-024-56807-7","volume":"14","author":"C Zaeske","year":"2024","unstructured":"Zaeske C, Zopfs D, Laukamp K, et al. Immediate angiographic control after intra-arterial nimodipine administration underestimates the vasodilatory effect. Sci Rep. 2024;14:6154. https:\/\/doi.org\/10.1038\/s41598-024-56807-7.","journal-title":"Sci Rep"},{"key":"4367_CR18","doi-asserted-by":"publisher","first-page":"2381","DOI":"10.1007\/s00234-022-03004-w","volume":"64","author":"L Donaldson","year":"2022","unstructured":"Donaldson L, Edington A, Vlok R, et al. The incidence of cerebral arterial vasospasm following aneurysmal subarachnoid haemorrhage: a systematic review and meta-analysis. 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Neurocrit Care. 2023;39(1):36\u201350. https:\/\/doi.org\/10.1007\/s12028-023-01747-9.","journal-title":"Neurocrit Care"}],"container-title":["CardioVascular and Interventional Radiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00270-026-04367-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00270-026-04367-w","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00270-026-04367-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T17:38:31Z","timestamp":1774546711000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00270-026-04367-w"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,16]]},"references-count":19,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2026,4]]}},"alternative-id":["4367"],"URL":"https:\/\/doi.org\/10.1007\/s00270-026-04367-w","relation":{},"ISSN":["1432-086X"],"issn-type":[{"value":"1432-086X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,16]]},"assertion":[{"value":"21 September 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"24 January 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"16 February 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare that they have no conflict of interest.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and\/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of study, formal consent is not required. This study has obtained IRB approval from (indicate the relevant board) and the need for informed consent was waived. For this type of study, consent for publication is not required.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical Approval"}}]}}