Document Detail

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.
MedLine Citation:
PMID:  20023546     Owner:  NLM     Status:  MEDLINE    
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).
Mitsuhisa Nishiguchi; Shigeki Ono; Keiichi Iseda; Hiroaki Manabe; Tomohito Hishikawa; Isao Date
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Neurosurgery     Volume:  66     ISSN:  1524-4040     ISO Abbreviation:  Neurosurgery     Publication Date:  2010 Jan 
Date Detail:
Created Date:  2009-12-21     Completed Date:  2010-03-02     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7802914     Medline TA:  Neurosurgery     Country:  United States    
Other Details:
Languages:  eng     Pagination:  158-64; discussion 164     Citation Subset:  IM    
Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Okayama, Japan.
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MeSH Terms
Angiography / methods
Basilar Artery / drug effects
Cyclic AMP / metabolism
Disease Models, Animal
Injections, Intra-Arterial / methods
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
Reg. No./Substance:
0/Phosphodiesterase Inhibitors; 60-92-4/Cyclic AMP; 78415-72-2/Milrinone

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