{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,14]],"date-time":"2026-04-14T07:00:50Z","timestamp":1776150050573,"version":"3.50.1"},"reference-count":20,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,10,31]],"date-time":"2025-10-31T00:00:00Z","timestamp":1761868800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,10,31]],"date-time":"2025-10-31T00:00:00Z","timestamp":1761868800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Universit\u00e4tsklinikum RWTH Aachen"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Neurol"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Delayed cerebral ischemia (DCI) is a major cause of morbidity after aneurysmal subarachnoid hemorrhage (SAH). Endovascular treatment (ET) has emerged as a rescue strategy, but its optimal timing, indication, and modality remain unclear. This study assessed international ET practices, focusing on treatment variability and clinical decision-making.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A 25-question survey was developed with input from specialists in interventional neuroradiology, neurosurgery, neurology, and neurocritical care. It was disseminated via professional societies to physicians involved in bedside decisions. Respondents reviewed clinical scenarios representing common DCI presentations, including proximal\/distal vasospasm and conscious\/unconscious patients. Descriptive analysis was performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>179 respondents from 38 countries participated; 76.5% reported ET availability at their institution. The most common strategy was single or repeated intra-arterial spasmolysis (76.5%), followed by continuous intra-arterial vasodilator infusion (23.0%). In unconscious patients, 50% applied spasmolysis as first-line treatment. For refractory proximal vasospasm, a stepwise approach was preferred, starting with intra-arterial pharmacologic spasmolysis, then angioplasty. While angioplasty was widely used, 66.5% considered it riskier than spasmolysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This survey highlights marked variability in ET practices for DCI. Intra-arterial spasmolysis is the predominant strategy, with alternative approaches like continuous infusion and angioplasty also in use. These findings underscore the need for randomized trials to define optimal ET strategies and inform evidence-based protocols for DCI following SAH.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12883-025-04480-2","type":"journal-article","created":{"date-parts":[[2025,10,31]],"date-time":"2025-10-31T12:53:19Z","timestamp":1761915199000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Endovascular treatment of delayed cerebral ischemia after aneurysmal subarachnoid hemorrhage \u2013 an international survey"],"prefix":"10.1186","volume":"25","author":[{"given":"Michael","family":"Veldeman","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thanh N.","family":"Nguyen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Johanna","family":"Ospel","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Charlotte S.","family":"Weyland","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"EYMINT survey and research committee","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,10,31]]},"reference":[{"issue":"4","key":"4480_CR1","doi-asserted-by":"publisher","first-page":"924","DOI":"10.1161\/STROKEAHA.110.597914","volume":"42","author":"MD Vergouwen","year":"2011","unstructured":"Vergouwen MD, Ilodigwe D, Macdonald RL. 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Clinical outcome in cerebral vasospasm patients treated with and without intra-arterial nimodipine infusion. J Neurol Surg A Cent Eur Neurosurg. 2022;83(5):420\u20136.","journal-title":"J Neurol Surg A Cent Eur Neurosurg"},{"issue":"1","key":"4480_CR12","doi-asserted-by":"publisher","first-page":"15","DOI":"10.1016\/j.neurad.2018.04.001","volume":"46","author":"D Adami","year":"2019","unstructured":"Adami D, Berkefeld J, Platz J, Konczalla J, Pfeilschifter W, Weidauer S, et al. Complication rate of intraarterial treatment of severe cerebral vasospasm after subarachnoid hemorrhage with nimodipine and percutaneous transluminal balloon angioplasty: worth the risk? 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In accordance with national regulations (\u00a715, Berufsordnung f\u00fcr die \u00c4rztinnen und \u00c4rzte in Nordrhein) and the decision of the ethics committee, the requirement for written informed consent was waived, as participation in the survey was voluntary, anonymous, and involved no personal or sensitive health information. This study was conducted in accordance with the Declaration of Helsinki.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"This manuscript does not contain identifiable images or data. The presented cases are fictional and constructed.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"448"}}