tailieunhanh - Ebook Cerebral vasospasm - Advances in research and treatment: Part 2

(BQ) Part 2 book “Cerebral vasospasm - Advances in research and treatment” has contents: Experimental treatments, clinical—doppler and imaging, clinical—medical aspects, clinical—medical management, clinical—surgery and endovascular, clinical—treatment. | SECTION V Experimental Treatments 36 Prevention of Experimental Cerebral Vasospasm by Intrathecal Delivery of Liposomal Fasudil YOSHIHIRO TAKANASHI, ., ., TATSUHIRO ISHIDA, ., JOHN H. ZHANG, ., ., ISAO YAMAMOTO, . Abstract We investigated the safety and efficacy of a sustained release form of liposo­ mal fasudil for the prevention of cerebral vasospasm after experimental subarachnoid hemorrhage (SAH) in rats and dogs. The safety of a large in­ trathecal dose of liposomal fasudil was tested in 18 rats. Rats were divided into one of three groups. Each group received either m g / k g or 5 m g / k g of liposomal fasudil or drug-free liposomes after SAH. Next, experimental SAH was induced in 15 dogs by injection of autologous arterial blood into the cisterna magna twice following baseline vertebral angiography. In six animals, m g / k g of liposomal fasudil was injected into the cisterna magna (treatment group). In four animals, drug-free liposomes were simi­ larly injected (placebo group), and the remaining five animals were treated with no liposomal injection after SAH (control group). On day 7 after SAH, angiography was repeated and cerebrospinal fluid was collected before sac­ rifice. In the safety study in rats, histological examination of the brains re­ vealed no abnormalities. In the placebo and control groups, significant vasospasm occurred in the canine basilar artery on day 7. In the treatment group, vasospasm on basilar artery was significantly ameliorated (p < .01). More than 90% of fasudil was released from the liposomes into the cere­ brospinal fluid. In conclusion, local delivery of liposomal fasudil is a safe and effective strategy for preventing vasospasm on experimental SAH. Intrathecal drug therapy for cerebral vasospasm following subarachnoid hemorrhage (SAH) has some advantages over systemic delivery and may be more efficacious than systemic application. 1–3 In the current study, we have devised a .