Effectiveness of Intraarterial Administration of Fasudil Hydrochloride for Preventing Symptomatic Vasospasm After Subarachnoid Hemorrhage

Saitô, Atsushi; Inoue, Masao; Kon, Hiroyuki; Imaruoka, Shunji; Basaki, Kiyoshi; Mizunuma, Hiroshi; Sasaki, Tatsuya; Nishijima, Michiharu

doi:10.1007/978-3-319-04981-6_50

Cited by 15 publications

(14 citation statements)

References 17 publications

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“…Fasudil has been primarily studied in Japan and is currently utilized in Japan for vasospasm prophylaxis . Because of the limited number of trials, it is not as popular elsewhere.…”

Section: Resultsmentioning

confidence: 99%

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Clinical and experimental aspects of aneurysmal subarachnoid hemorrhage

et al. 2019

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Aneurysmal subarachnoid hemorrhage (aSAH) continues to be associated with significant morbidity and mortality despite advances in care and aneurysm treatment strategies. Cerebral vasospasm continues to be a major source of clinical worsening in patients. We intended to review the clinical and experimental aspects of aSAH and identify strategies that are being evaluated for the treatment of vasospasm. A literature review on aSAH and cerebral vasospasm was performed. Available treatments for aSAH continue to expand as research continues to identify new therapeutic targets. Oral nimodipine is the primary medication used in practice given its neuroprotective properties. Transluminal balloon angioplasty is widely utilized in patients with symptomatic vasospasm and ischemia. Prophylactic “triple‐H” therapy, clazosentan, and intraarterial papaverine have fallen out of practice. Trials have not shown strong evidence supporting magnesium or statins. Other calcium channel blockers, milrinone, tirilazad, fasudil, cilostazol, albumin, eicosapentaenoic acid, erythropoietin, corticosteroids, minocycline, deferoxamine, intrathecal thrombolytics, need to be further investigated. Many of the current experimental drugs may have significant roles in the treatment algorithm, and further clinical trials are needed. There is growing evidence supporting that early brain injury in aSAH may lead to significant morbidity and mortality, and this needs to be explored further.

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“…Fasudil has been primarily studied in Japan and is currently utilized in Japan for vasospasm prophylaxis . Because of the limited number of trials, it is not as popular elsewhere.…”

Section: Resultsmentioning

confidence: 99%

“…Fasudil has been primarily studied in Japan and is currently utilized in Japan for vasospasm prophylaxis. 89 Because of the limited number of trials, it is not as popular elsewhere. Large randomized, controlled clinical trials are needed to further establish the benefit of fasudil in aSAH.…”

Section: Fasudilmentioning

confidence: 99%

Clinical and experimental aspects of aneurysmal subarachnoid hemorrhage

et al. 2019

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“…Fasudil [1-(5-isoquinolinesulfonyl)-homopiperazine] is a well-described orally available Rho kinase inhibitor, 26 which has been approved in Japan and China for the treatment of cerebral vasospasm following surgery for associated cerebral ischemic symptoms. 29 Following p.o. administration, Fasudil is converted into the active metabolite 1-(hydroxy-5-isoquinoline sulfonyl-homopipera-zine) (Fasudil-OH).…”

Section: Discussionmentioning

confidence: 99%

RhoA‐stimulated intra‐capillary morphology switch facilitates the arrest of individual circulating tumor cells

Huang

Zhao

et al. 2018

Intl Journal of Cancer

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Metastasis is the primary cause of death for most cancer patients. Hematogenous arrest of circulating tumor cells (CTCs) is an essential prerequisite for metastases formation. Using transparent transgenic zebrafish (kdrl:eGFP; Casper), together with resonant laser scanning confocal microscopy, we tracked the fate of CTCs in vivo in the blood circulation for days. We found the intra-capillary morphology-switch (ICMS) of individual CTCs from strip to sphere was necessary for their intravascular arrests. Further genetic and pharmacological inhibition experiments indicated that the RhoA signaling was necessary for ICMS and the arrest of CTCs. At last, we demonstrated that early treatment by a clinically approved RhoA/ROCK inhibitor, Fasudil, could efficiently inhibit the initial arrest of individual CTCs and reduce the incidence of tumor metastasis in both zebrafish and mouse models. These results together indicate that RhoA-stimulated ICMS represents a mechanism for the arrest of individual CTCs, providing a potential target for future treatments of hematogenous metastatic disease.

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“…Rock contributes to vasoconstriction via activation of multiple molecular targets including Ca 2+ sensitization of the VSMC contractile apparatus, actin polymerization and actin filament stabilization (20). Clinical trials have shown that Rock inhibition is an additional therapeutic option to resolve vasospasms (21,22 (1)(2)(3)(4).…”

Section: Discussionmentioning

confidence: 99%

“…ET-1 may activate the RhoA-rho-kinase (Rock) pathway in mesenteric arterial vascular smooth muscle cells (VSMCs) which sensitizes the contractile apparatus to Ca 2+ causing a hyper-contractile state that leads to vasospasms (20). Rock inhibitors have been shown to resolve coronary and cerebral arterial spasms in patients (21,22) while data on the potential of Rock inhibitors to antagonize vasoconstrictions in human mesenteric arteries are sparse. Therefore, the aims of this study were 1) to characterize the responses of human mesenteric arteries to physiological vasoconstrictors that may contribute to the development of NOMI;…”

Section: Introductionmentioning

confidence: 99%

Iloprost, Prostaglandin E1, and Papaverine Relax Human Mesenteric Arteries With Similar Potency

Mahlke

Kühn

Mensel

et al. 2017

Shock

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Effectiveness of Intraarterial Administration of Fasudil Hydrochloride for Preventing Symptomatic Vasospasm After Subarachnoid Hemorrhage

Abstract: IAFC significantly reduced the cerebral circulation time after aneurysmal SAH and might be effective for the prevention of symptomatic vasospasm.

Cited by 15 publications

References 17 publications

Clinical and experimental aspects of aneurysmal subarachnoid hemorrhage

Clinical and experimental aspects of aneurysmal subarachnoid hemorrhage

RhoA‐stimulated intra‐capillary morphology switch facilitates the arrest of individual circulating tumor cells

Iloprost, Prostaglandin E1, and Papaverine Relax Human Mesenteric Arteries With Similar Potency

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