Top

Neuroradiology

Published in:

01-09-2010 | Interventional Neuroradiology

Intra-arterial colforsin daropate for the treatment of cerebral vasospasm after aneurysmal subarachnoid hemorrhage

Authors: Satoshi Suzuki, Osamu Ito, Tetsuro Sayama, Katsuya Goto

Published in: Neuroradiology | Issue 9/2010

Abstract

Introduction

Cerebral vasospasm (CV) remains a major cause of mortality and morbidity in patients with subarachnoid hemorrhage (SAH). Here, we examined the effectiveness and safety of intra-arterial injection of colforsin daropate hydrochloride (CDH).

Methods

A consecutive series of 29 patients with angiographically confirmed CV received intra-arterial CDH (IAC) therapy. Angiographic changes in spastic vessels and the cerebral circulation time (CCT) were assessed before and after IAC treatment, together with the change in clinical status.

Results

IAC treatment was performed in 53 procedures in 29 patients. Angiographic improvement was observed following all procedures (100%), and clinical improvement was observed following 36 of 42 procedures (86%) in symptomatic cases. CCT improved significantly. At the 3-month follow-up, 19 patients (66%) showed good recovery or moderate disability on the Glasgow Outcome Scale. Major adverse effects were headache and increased heart rate.

Conclusions

IAC treatment was effective and safe for the treatment of CV after SAH

Macdonald RL (2006) Management of cerebral vasospasm. Neurosurg Rev 29:179–193CrossRef

Eskridge JM, Song JK (1997) A practical approach to the treatment of vasospasm. Am J Neuroradiol 18:1653–1660PubMed

Hosono M, Takahira T, Fujita A, Fujihara R, Ishizuka O, Tatee T, Nakamura K (1992) Cardiovascular and adenylate cyclase stimulant properties of NKH477, a novel water-soluble forskolin derivative. J Cardiovasc Pharmacol 19(4):625–634CrossRefPubMed

Shafiq J, Suzuki S, Itoh T, Kuriyama H (1992) Mechanisms of vasodilation induced by NKH477, a water-soluble forskolin derivative, in smooth muscle of the porcine coronary artery. Circ Res 71:70–81PubMed

Aaslid R, Huber P, Nomes H (1984) Evaluation of cerebrovascular spasm with transcranial Doppler ultrasound. J Neurosurg 60:37–41CrossRefPubMed

Suzuki S, Ito O, Sayama T, Yamaguchi S, Goto K, Sasaki T (2006) Intraarterial injection of colforsin daropate hydrochloride for the treatment of vasospasm after aneurysmal subarachnoid hemorrhage: preliminary report of two cases. Neuroradiology 48:50–53CrossRefPubMed

Kaku Y, Yonekawa Y, Tsukahara T, Kazekawa K (1992) Superselective intra-arterial infusion of papaverine for the treatment of cerebral vasospasm after subarachnoid hemorrhage. J Neurosurg 77:842–847CrossRefPubMed

Kassell NF, Helm G, Simmons N, Phillips CD, Cail WS (1992) Treatment of cerebral vasospasm with intra-arterial papaverine. J Neurosurg 77:848–852CrossRefPubMed

Smith WS, Dowd CF, Johnston SC, Ko NU, DeArmond SJ, Dillon WP, Setty D, Lawton MT, Young WL, Higashida RT, Halbach VV (2004) Neurotoxicity of intra-arterial papaverine preserved with chlorobutanol used for the treatment of cerebral vasospasm after aneurysmal subarachnoid hemorrhage. Stroke 35:2518–2522CrossRefPubMed

10.

Yoshimura S, Hashimoto N, Goto Y, Sampei K, Tsukahara T, Iihara K (1996) Intraarterial infusion of high-concentration papaverine damages cerebral arteries in rats. Am J Neuroradiol 17:1891–1894PubMed

11.

Polin RS, Hansen CA, German P, Chadduck JB, Kassell NF (1998) Intra-arterially administered papaverine for the treatment of symptomatic cerebral vasospasm. Neurosurgery 42:1256–1267CrossRefPubMed

12.

Biondi A, Ricciardi GK, Puybasset L, Abdennour L, Longo M, Chiras J, Van Effenterre R (2004) Intra-arterial nimodipine for the treatment of symptomatic cerebral vasospasm after aneurysmal subarachnoid hemorrhage: preliminary results. Am J Neuroradiol 25:1067–1076PubMed

13.

Tachibana E, Harada T, Shibuya M, Saito K, Takayasu M, Suzuki Y, Yoshida J (1999) Intra-arterial infusion of fasudil hydrochloride for treating vasospasm following subarachnoid hemorrhage. Acta Neurochir 141:13–19CrossRef

14.

Tanaka K, Minami H, Kota M, Kuwamura K, Kohmura E (2005) Treatment of cerebral vasospasm with intra-arterial fasudil hydrochloride. Neurosurgery 56:214–223CrossRefPubMed

15.

Arakawa Y, Kikuta K, Hojo M, Goto Y, Ishii A, Yamagata S (2001) Milrinone for the treatment of cerebral vasospasm after subarachnoid hemorrhage: report of seven cases. Neurosurgery 48:723–730CrossRefPubMed

16.

Yoshida K, Watanabe H, Nakamura S (1997) Intraarterial injection of amrinone for vasospasm induced by subarachnoid hemorrhage. Am J Neuroradiol 18:492–496PubMed

17.

Molyneux AJ, Kerr RS, Yu LM, Clarke M, Sneade M, Yarnold JA, Sandercock P, International Subarachnoid Aneurysm Trial (ISAT) Collaborative Group (2005) International Subarachnoid Aneurysm Trial (ISAT) of neurosurgical clipping versus endovascular coiling in 2143 patients with ruptured intracranial aneurysms: a randomized comparison of effects on survival, dependency, seizures, rebleeding, subgroups, and aneurysm occlusion. Lancet 366:809–817CrossRefPubMed

Title: Intra-arterial colforsin daropate for the treatment of cerebral vasospasm after aneurysmal subarachnoid hemorrhage
Authors: Satoshi Suzuki
Osamu Ito
Tetsuro Sayama
Katsuya Goto
Publication date: 01-09-2010
Publisher: Springer-Verlag
Published in: Neuroradiology / Issue 9/2010
Print ISSN: 0028-3940
Electronic ISSN: 1432-1920
DOI: https://doi.org/10.1007/s00234-009-0631-7

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Intra-arterial colforsin daropate for the treatment of cerebral vasospasm after aneurysmal subarachnoid hemorrhage

Abstract

Introduction

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Introduction

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 9/2010

Foreword

CT-guided spinal injection: initial experience with Sprotte tip needles

In vitro comparison of different carotid artery stents: a pixel-by-pixel analysis using CT angiography and contrast-enhanced MR angiography at 1.5 and 3 T

Fragmentation of calcified plaque after carotid artery stenting in heavily calcified circumferential stenosis

In vitro evaluation of the sinus sagittalis superior thrombosis model in the rat using 3D micro- and nanocomputed tomography

Applications of diffusion-weighted magnetic resonance imaging in head and neck squamous cell carcinoma