| Effect of vasodilation by milrinone, a phosphodiesterase III inhibitor, on vasospastic arteries after a subarachnoid hemorrhage in vitro and in vivo: effectiveness of cisternal injection of milrinone. | |
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MedLine Citation:
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PMID: 20023546 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: Cerebral vasospasm remains a major cause of morbidity and mortality. Milrinone, a bipyridine phosphodiesterase III inhibitor, is a potent member of the inodilator class of cardiac agents for vasospasm and is injected intra-arterially or intracisternally. There have been no studies investigating the duration of action (context-sensitive half-life) of milrinone for vasospasm or the most effective route of administration (intra-arterial versus intracisternal). We examined the effects of intracisternal and intra-arterial injection of milrinone on chronic cerebral vasospasm in dogs. METHODS: A double-hemorrhage canine model was used. In a preliminary isometric tension study of canine vasospastic basilar arteries, the vasodilatory effects of milrinone were examined 7 days after an initial injection of blood. Milrinone was injected intracisternally (0.1 mg, 0.47 mmol/L) or intra-arterially (0.3 mg/kg, 1.2 mmol/L), and angiograms were performed 30, 60, 120, 180, 240, 300, and 360 minutes later on day 7. RESULTS: Milrinone produced concentration-dependent vasodilation and was effective intracisternally, resulting in significant dilation until 180 minutes after injection and a tendency for dilation until 240 minutes. The effect of intra-arterial injection was not as significant compared with an intracisternal injection, resulting in significant dilation only at 180 minutes after intra-arterial injection. CONCLUSION: Intracisternal injection of milrinone was more effective than intra-arterial injection for chronic cerebral vasospasm in dogs because intracisternal injection produced a higher concentration in vasospastic arteries (0.034-0.068 mmol/L intracisternally versus 0.016 mmol/L intra-arterially). |
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Authors:
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Mitsuhisa Nishiguchi; Shigeki Ono; Keiichi Iseda; Hiroaki Manabe; Tomohito Hishikawa; Isao Date |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Neurosurgery Volume: 66 ISSN: 1524-4040 ISO Abbreviation: Neurosurgery Publication Date: 2010 Jan |
Date Detail:
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Created Date: 2009-12-21 Completed Date: 2010-03-02 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7802914 Medline TA: Neurosurgery Country: United States |
Other Details:
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Languages: eng Pagination: 158-64; discussion 164 Citation Subset: IM |
Affiliation:
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Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Okayama, Japan. nisiguti@iwakuni-nh.go.jp |
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| MeSH Terms | |
Descriptor/Qualifier:
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Angiography
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methods Animals Basilar Artery / drug effects Cyclic AMP / metabolism Disease Models, Animal Dogs Female Injections, Intra-Arterial / methods Male Milrinone / pharmacology, therapeutic use* Muscle Contraction / drug effects Muscle, Smooth, Vascular / drug effects Phosphodiesterase Inhibitors / pharmacology, therapeutic use* Subarachnoid Hemorrhage / complications, veterinary Time Factors Vasodilation / drug effects Vasospasm, Intracranial / drug therapy*, etiology, pathology, veterinary |
| Chemical | |
Reg. No./Substance:
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0/Phosphodiesterase Inhibitors; 60-92-4/Cyclic AMP; 78415-72-2/Milrinone |
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