How effective is the combination of intraarterial Milrinone and Nimodipine in treating severe refractory cerebral vasospasm (VSP)?

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Topic
The study evaluates the combined effect of intraarterial Milrinone and Nimodipine in patients with refractory VSP who have not responded to maximum standard conservative therapy. The combination therapy is administered as a rescue treatment to improve vessel diameter and neurological outcomes.
Answer
The combination of intraarterial Milrinone and Nimodipine showed promising clinical results, with immediate improvement of neurological deficits in 81.6% of patients and a low mortality rate of 7.9%. Angiographic improvement was observed in 97.7% of interventions, with a mean vessel diameter improvement of 69.9% after the application of both substances. The additional vasodilatory effect of Milrinone over Nimodipine alone was 62.6%.
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