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Effectiveness of Intraarterial Administration of Fasudil Hydrochloride for Preventing Symptomatic Vasospasm After Subarachnoid Hemorrhage

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Neurovascular Events After Subarachnoid Hemorrhage

Part of the book series: Acta Neurochirurgica Supplement ((NEUROCHIRURGICA,volume 120))

Abstract

Objective: We examined the effect of intraarterial administration of fasudil hydrochloride (IAFC), a Rho kinase inhibitor, for the prevention of symptomatic vasospasm after SAH by evaluating cerebral circulation.

Methods: We evaluated IAFC cases of 57 sides of 38 patients (12 men and 26 women, average age 60.2 years old) diagnosed with aneurysmal subarachnoid hemorrhage (SAH) from February 2012 to November 2012. All cases were treated by clipping or coil embolization within 48 h after onset. Indication for IAFC was the existence of a spastic change on follow-up digital subtraction angiography (DSA) compared with that of onset.

Results: Clipping was performed in 30 cases and coil embolization in 8 cases. IAFC was performed an average of 6.6 days after onset. Color gradient mapping demonstrated reduction of the circulation time after IAFC compared with before IAFC on 39 sides, no change on 15 sides, and extension on 3 sides. Average arterial circulation time before IAFC was 2.25 ± 0.57 s and after IAFC was 1.95 ± 0.55 s. IAFC significantly shortened average arterial circulation (P = 0.005). No case developed symptomatic vasospasm after IAFC.

Conclusion: IAFC significantly reduced the cerebral circulation time after aneurysmal SAH and might be effective for the prevention of symptomatic vasospasm.

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Conflict of Interest Statement

We declare that we have no conflict of interest.

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Authors and Affiliations

  1. Departments of Neurosurgery and Radiology, Aomori Prefectural Central Hospital, 2-1-1 Higashitsukurimichi, Aomori, 0308553, Japan

    Atsushi Saito MD, PhD, Mizuho Inoue, Hiroyuki Kon, Shunji Imaruoka, Kiyoshi Basaki, Hiroshi Midorikawa, Tatsuya Sasaki & Michiharu Nishijima

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  1. Atsushi Saito MD, PhD
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  2. Mizuho Inoue
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  3. Hiroyuki Kon
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  4. Shunji Imaruoka
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  5. Kiyoshi Basaki
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  6. Hiroshi Midorikawa
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  7. Tatsuya Sasaki
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  8. Michiharu Nishijima
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Corresponding author

Correspondence to Atsushi Saito MD, PhD .

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Editors and Affiliations

  1. Department of Neurosurgery, Kantonsspital Aarau, Aarau, Switzerland

    Javier Fandino

  2. Department of Neurosurgery, Kantonsspital Aarau, Aarau, Switzerland

    Serge Marbacher

  3. Department of Neurosurgery, Kantonsspital Aarau, Aarau, Switzerland

    Ali-Reza Fathi

  4. Department of Neurosurgery, Kantonsspital Aarau, Aarau, Switzerland

    Carl Muroi

  5. Department of Neurosurgery Neurointensive Care Unit, University Hospital Zurich, Zurich, Switzerland

    Emanuela Keller

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Saito, A. et al. (2015). Effectiveness of Intraarterial Administration of Fasudil Hydrochloride for Preventing Symptomatic Vasospasm After Subarachnoid Hemorrhage. In: Fandino, J., Marbacher, S., Fathi, AR., Muroi, C., Keller, E. (eds) Neurovascular Events After Subarachnoid Hemorrhage. Acta Neurochirurgica Supplement, vol 120. Springer, Cham. https://doi.org/10.1007/978-3-319-04981-6_50

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  • DOI: https://doi.org/10.1007/978-3-319-04981-6_50

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-04980-9

  • Online ISBN: 978-3-319-04981-6

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