PMID- 35250795
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220502
IS  - 1664-2295 (Print)
IS  - 1664-2295 (Electronic)
IS  - 1664-2295 (Linking)
VI  - 12
DP  - 2021
TI  - Adverse Events and Complications in Continuous Intra-arterial Nimodipine Infusion 
      Therapy After Aneurysmal Subarachnoid Hemorrhage.
PG  - 812898
LID - 10.3389/fneur.2021.812898 [doi]
LID - 812898
AB  - OBJECTIVE: To determine the frequency and severity of complications associated 
      with the continuous intra-arterial infusion of nimodipine (CIANI) as a new 
      treatment of delayed cerebral ischemia (DCI) after aneurysmal subarachnoid 
      hemorrhage (SAH). METHODS: Patients from two centers (n = 718) treated for SAH 
      between 2008 and 2016 were included. Demographic and SAH-related parameters were 
      evaluated, and also the frequency of adverse events (AEs) and complications 
      including their severity (mild, moderate, and severe). Clinical outcome was 
      analyzed using Glasgow Outcome Scale (GOS). The unfavorable outcome was defined 
      as GOS 1 to 3, and favorable outcome as GOS 4 to 5. The Short-Form 36 (SF-36) 
      health-related quality-of-life (QoL) questionnaire served as a QoL measurement. 
      RESULTS: Of 718 patients, 65 (9%) were treated by CIANI and had a higher clinical 
      or imaging grade of bleeding severity. Clinical deterioration while on treatment 
      happened more often in patients who were treated with CIANI than in others. In 
      patients with CIANI, 67% had AEs and/or complications during the treatment. 
      Nimodipine-associated hypotension was seen in 8% (mild). Catheter-associated 
      thrombus occurred in 9% (moderate). New intracerebral hemorrhage was found in 14% 
      (moderate). A total of 6% treated by CIANI died during the treatment period 
      (severe). More than one-third (39%) of patients of CIANI reached at least 
      moderate disability, and 23% showed good recovery. Patients who received CIANI 
      showed reduced QoL, but differences in mental and general health, and also pain 
      were minimal. CONCLUSION: Patients who received CIANI had higher rates of AEs and 
      complications. However, this does not exclude the possibility that the use of 
      CIANI might be helpful in patients with severe and therapy-refractory CV and DCI. 
      Controlled and randomized studies would be helpful to clarify this question but 
      they are methodologically and ethically challenging.
CI  - Copyright (c) 2022 Kapapa, Konig, Mayer, Braun, Schmitz, Muller, Schick, Wirtz and 
      Pala.
FAU - Kapapa, Thomas
AU  - Kapapa T
AD  - Department of Neurosurgery, University Hospital Ulm, Ulm, Germany.
FAU - Konig, Ralph
AU  - Konig R
AD  - Department of Neurosurgery, University of Ulm, Bezirkskrankenhaus Gunzburg, 
      Gunzburg, Germany.
FAU - Mayer, Benjamin
AU  - Mayer B
AD  - Institute of Epidemiology and Medical Biometry, University of Ulm, Ulm, Germany.
FAU - Braun, Michael
AU  - Braun M
AD  - Section Neuroradiology, University Hospital Ulm, Gunzburg, Germany.
FAU - Schmitz, Bernd
AU  - Schmitz B
AD  - Section Neuroradiology, University Hospital Ulm, Gunzburg, Germany.
FAU - Muller, Silwia
AU  - Muller S
AD  - Department of Neurosurgery, University Hospital Ulm, Ulm, Germany.
FAU - Schick, Julia
AU  - Schick J
AD  - Section Interdisciplinary Operative Intensive Care Medicine, University Hospital 
      Ulm, Ulm, Germany.
FAU - Wirtz, Christian Rainer
AU  - Wirtz CR
AD  - Department of Neurosurgery, University Hospital Ulm, Ulm, Germany.
AD  - Department of Neurosurgery, University of Ulm, Bezirkskrankenhaus Gunzburg, 
      Gunzburg, Germany.
FAU - Pala, Andrej
AU  - Pala A
AD  - Department of Neurosurgery, University of Ulm, Bezirkskrankenhaus Gunzburg, 
      Gunzburg, Germany.
LA  - eng
PT  - Journal Article
DEP - 20220218
PL  - Switzerland
TA  - Front Neurol
JT  - Frontiers in neurology
JID - 101546899
PMC - PMC8895039
OTO - NOTNLM
OT  - cerebral vasospasm
OT  - delayed cerebral ischemia
OT  - endovascular therapy
OT  - outcome
OT  - risk factors
COIS- The authors declare that the research was conducted in the absence of any 
      commercial or financial relationships that could be construed as a potential 
      conflict of interest.
EDAT- 2022/03/08 06:00
MHDA- 2022/03/08 06:01
PMCR- 2022/02/18
CRDT- 2022/03/07 06:02
PHST- 2021/11/10 00:00 [received]
PHST- 2021/12/30 00:00 [accepted]
PHST- 2022/03/07 06:02 [entrez]
PHST- 2022/03/08 06:00 [pubmed]
PHST- 2022/03/08 06:01 [medline]
PHST- 2022/02/18 00:00 [pmc-release]
AID - 10.3389/fneur.2021.812898 [doi]
PST - epublish
SO  - Front Neurol. 2022 Feb 18;12:812898. doi: 10.3389/fneur.2021.812898. eCollection 
      2021.