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Clinical Trial of Nicardipine Prolonged-Release Implants for Preventing Cerebral Vasospasm: Multicenter Cooperative Study in Tokyo

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Part of the Acta Neurochirurgica Supplements book series (NEUROCHIRURGICA,volume 110/2)

Abstract

Background: Since October 1999, nicardipine pellets (NP) have been used to prevent vasospasm in patients with subarachnoid hemorrhage (SAH). We started a multicenter cooperative study on Jan 1, 2007, and 136 patients in six hospitals were enrolled to this trial in 2 years. The incidence of cerebral vasospasm and outcome were examined in these patients.

Methods: The patients with SAH were treated with NP during surgery after clipping of their aneurysms.

Findings: The study included 87 female patients, 38 over 70 years old, 34 in grades 4 and 5, and 46 of Fisher group 2 or 4. Aneurysms were located on anterior circulation in 133, posterior in 3. All patients were treated with Fasudil hydrochloride except for 3. Two to twelve pellets were implanted in the cistern where thick clots existed and vasospasm was highly likely. Delayed ischemic neurological deficits (DIND), angiographical vasospasm and cerebral infarctions were seen in 11 of 134 (8.2%), 32 of 130 patients (24.6%), and 16 of 129 (12.4%), respectively. No complications were experienced. Independent rate at 3 months was 78%.

Conclusions: The incidence of cerebral vasospasm in this multicenter trial is similar to that of our first trial performed in a single center.

Keywords

  • Drug delivery system
  • Nicardipine
  • Subarachnoid hemorrhage
  • Cerebral vasospasm

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Acknowledgements

This work was supported in part by a grant-in-aid for scientific research (C) from the Japanese Ministry of Education, Culture, Sports, Science, and Technology.

Conflict of interest statement We declare that we have no conflict of interest.

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Correspondence to H. Kasuya .

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Kasuya, H. (2011). Clinical Trial of Nicardipine Prolonged-Release Implants for Preventing Cerebral Vasospasm: Multicenter Cooperative Study in Tokyo. In: Feng, H., Mao, Y., Zhang, J.H. (eds) Early Brain Injury or Cerebral Vasospasm. Acta Neurochirurgica Supplements, vol 110/2. Springer, Vienna. https://doi.org/10.1007/978-3-7091-0356-2_30

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  • DOI: https://doi.org/10.1007/978-3-7091-0356-2_30

  • Publisher Name: Springer, Vienna

  • Print ISBN: 978-3-7091-0355-5

  • Online ISBN: 978-3-7091-0356-2

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