Document Detail


Efficacy and safety of nicardipine prolonged-release implants for preventing vasospasm in humans.
MedLine Citation:
PMID:  11935053     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND PURPOSE: Despite extensive investigative efforts, there are few treatments that can prevent vasospasm after subarachnoid hemorrhage. This study was conducted to examine the efficacy and safety of nicardipine prolonged-release implants (NPRI) for humans, which have already been proven in dogs. METHODS: Twenty consecutive subarachnoid hemorrhage patients with thick subarachnoid clot were treated with NPRI (a pellet of diameter 2 mm, length 10 mm, containing 4 mg of nicardipine) during surgery after clipping of their aneurysm. The number and location of pellets depended on the amount and site of subarachnoid clot on preoperative CT and on craniotomy. RESULTS: Two to 10 pellets were implanted in the cistern of the internal carotid, middle cerebral, and/or anterior cerebral artery, where thick clots existed and therefore vasospasm related to delayed ischemic neurological deficits was highly likely. Delayed ischemic neurological deficits and cerebral infarctions were seen in 1 patient. Angiography performed on days 7 to 12 revealed no vasospasm in any arteries near which NPRI were placed. No complications were experienced. CONCLUSIONS: Vasospasm was completely prevented for the arteries in thick clot cisterns, when NPRI were placed adjacent to the arteries during surgery. This drug-delivery system offers a promising approach for preventing vasospasm.
Authors:
Hidetoshi Kasuya; Hideaki Onda; Mikihiko Takeshita; Yoshikazu Okada; Tomokastu Hori
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Publication Detail:
Type:  Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Stroke; a journal of cerebral circulation     Volume:  33     ISSN:  1524-4628     ISO Abbreviation:  Stroke     Publication Date:  2002 Apr 
Date Detail:
Created Date:  2002-04-05     Completed Date:  2002-04-16     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0235266     Medline TA:  Stroke     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1011-5     Citation Subset:  IM    
Affiliation:
Department of Neurosurgery, Tokyo Women's Medical University, Tokyo, Japan. hkasuya@nij.twmu.ac.jp
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MeSH Terms
Descriptor/Qualifier:
Aged
Anterior Cerebral Artery / drug effects,  radiography,  surgery
Carotid Artery, Internal / drug effects,  radiography,  surgery
Cerebral Angiography
Craniotomy
Delayed-Action Preparations / administration & dosage
Drug Evaluation
Drug Implants / administration & dosage
Female
Humans
Male
Middle Aged
Middle Cerebral Artery / drug effects,  radiography,  surgery
Nicardipine / administration & dosage*
Postoperative Complications / prevention & control
Subarachnoid Hemorrhage / complications,  drug therapy*,  surgery
Treatment Outcome
Vascular Surgical Procedures
Vasospasm, Intracranial / etiology,  prevention & control*
Chemical
Reg. No./Substance:
0/Delayed-Action Preparations; 0/Drug Implants; 55985-32-5/Nicardipine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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