PMID: 8587685Jul 1, 1995Paper

A randomized trial of intraoperative, intracisternal tissue plasminogen activator for the prevention of vasospasm

Neurosurgery
J M FindlayN W Knuckey

Abstract

A multicenter, randomized, blinded, placebo-controlled trial was conducted to study the possible role of intracisternally administered fibrinolytic agent recombinant tissue plasminogen activator (rt-PA) in preventing delayed onset cerebral vasospasm following aneurysmal subarachnoid hemorrhage (SAH). The target population was patients with ruptured saccular aneurysms causing severe SAH, placing them at high risk for vasospasm. Treatment consisted of a single 10 ml intraoperative injection of either vehicle buffer solution or rt-PA (1 mg/ml) into the opened basal subarachnoid cisterns immediately following aneurysm clipping. The major efficacy endpoint in this trial was angiographic vasospasm, and the major safety concern was intracranial hemorrhage. One hundred patients were randomized, 49 to placebo and 51 to rt-PA treatment. Baseline population characteristics were similar between the two groups. Severity of intracranial hemorrhage on computed tomographic scans was also similar between groups: 87.2% of both placebo and rt-PA treated patients had thick subarachnoid clots, and the rates for intracerebral and intraventricular hemorrhage were, respectively, 16.3% and 22.5% for placebo and 23.5% and 21.6% for rt-PA. Nine randomize...Continue Reading

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Citations

Sep 20, 2007·Der Anaesthesist·A S SarrafzadehW Boemke
Feb 28, 2006·Neurosurgical Review·R Loch Macdonald
Oct 3, 2008·Neurosurgical Review·Uzma Samadani, Veit Rohde
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Oct 29, 2004·Neurosurgery·Norberto Andaluz, Mario Zuccarello
Oct 21, 2006·Neurosurgery·Marike Zwienenberg-LeeJan Paul Muizelaar
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Oct 13, 2006·Neurosurgical Focus·George W WeyerR Loch Macdonald
Feb 1, 1996·Journal of Neurosurgery·C Ogilvy, I S Choi

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