Abstract
Background: We investigated the clinical efficacy of intra-arterial administration of fasudil hydrochloride for cerebral vasospasm.
Method: We reviewed 90 cases treated with intra-arterial administration of fasudil hydrochloride between August 1998 and April 2009 and investigated the clinical efficacy for cerebral vasospasm.
Findings: Angiographic improvement of vasospasm was noted in all procedures. Eight had ischemic lesion on CT at discharge in Group A, which included 39 patients who presented angiographic and symptomatic vasospasm. However, 4 (50%) of these eight were recovered with a condition of GR. No patients showed ischemic lesion on CT in Group B, which included 51 patients who presented angiographic vasospasm without symptoms. Two (3.3%) of 59 patients who presented angiographic vasospasm without symptoms at the initial follow-up angiography had ischemic lesion on CT at discharge. The 1-year follow-up showed 78.9% of GR. No patient showed any adverse effects resulting from intra-arterial administration of fasudil hydrochloride.
Conclusion: Intra-arterial administration of fasudil hydrochloride was an effective and safe management technique for vasospasm.
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References
Asano T, Suzuki T, Tsuchiya M, Satoh S, Ikegaki I, Shibuya M, et al. Vasodilator actions of HA1077 in vitro and in vivo putatively mediated by the inhibition of protein kinase. Br J Pharmacol. 1989;98:1091–1100.
Clouston JE, Numaguchi Y, Zoarski GH, Aldrich EF, Simard JM, Zitnay KM. Intraarterial papaverine infusion for cerebral vasospasm after subarachnoid hemorrhage. AJNR Am J Neuroradiol. 1995;16:27–38.
Hoh BL, Ogilvy CS. Endovascular treatment of cerebral vasospasm: transluminal balloon angioplasty, intra-arterial papaverine, and intra-arterial nicardipine. Neurosurg Clin N Am. 2005;16: 501–516.
Ito K, Shimomura E, Iwanaga T, Shiraishi M, Shindo K, Nakamura J, et al. Essential role of rho kinase in the Ca2+sensitization of prostaglandin F2α-induced contraction of rabbit aortae. J Physiol. 2003;546:823–836.
Iwabuchi S, Yokouchi T, Hayashi M, Uehara H, Ueda M, Samejima H. Intra-arterial administration of fasudil hydrochloride for vasospasm following subarachnoid hemorrhage: analysis of time-density curve with digital subtraction angiography. Neurol Med Chir (Tokyo). 2006;46:535–540.
Jannett B, Bond M. Assessment of outcome after severe brain damage. A practical scale. Lancet 1975;1:480–484.
Masaoka H, Takasato Y, Nojiri T, Hayakawa T, Akimoto H, Yatsushige H, et al. Clinical effect of Fasudil hydrochloride for cerebral vasospasm following subarachnoid hemorrhage. Acta Neurochir Suppl (Wien). 2001;77:209–211.
Mathis JM, Jensen ME, Dion JE. Technical considerations on intra-arterial papaverine hydrochloride for cerebral vasospasm. Neuroradiology 1997;39:90–98.
Satoh S, Yamamoto Y, Toshima Y, Ikegaki I, Asano T, Suzuki Y, et al. Fasudil, a protein kinase inhibitor, prevents the development of endothelial injury and neutrophil infiltration in a two-haemorrhage canine subarachnoid model. J Clin Neurosci. 1999;6:394–399.
Seto M, Takuwa Y, Sasaki Y. The molecular mechanism of vasospasm and the attenuation by fasudil. Nippon Yakurigaku Zasshi. 1992;114:66–70.
Shibuya M, Suzuki Y, Sugita K, Saito I, Sasaki T, Takakura K, et al. Effect of AT877 on cerebral vasospasm after aneurysmal subarachnoid hemorrhage. J Neurosurg. 1992;76:571–577.
Shimokawa H, Seto M, Katsumata N, Amano M, Kozai T, Yamawaki T, et al. Rho-kinase-mediated pathway induces enhanced myosin light chain phosphorylations in a swine model of coronary artery spasm. Cardiovasc Res. 1999;43:1029–1039.
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Iwabuchi, S. et al. (2011). Intra-arterial Administration of Fasudil Hydrochloride for Vasospasm Following Subarachnoid Haemorrhage: Experience of 90 Cases. 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_33
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