Intro-arterial Administration of Fasudil Hydrochloride for Vasospasm Following Subarachnoid Hemorrhage-Analysis of Time-Density Curve With Digital Subtraction Angiography-

Abstract

The cerebral circulatory dynamics were evaluated before and after intra-arterial administration of fasudil hydrochloride in 20 patients with angiographic vasospasm after subarachnoid hemorrhage (SAH). The region of interest time-density curves obtained before and after intra-arterial administration of fasudil hydrochloride were compared in the proximal portion of the middle cerebral artery in the early arterial phase, the distal portion of the middle cerebral artery in the late arterial phase, and the transverse sinus in the venous phase. In the early arterial phase, the time to peak and the time to halfpeak were significantly reduced. In the late arterial phase and venous phase, the time to peak was significantly reduced. These results suggest that intra-arterial administration of fasudil hydrochloride induced dilation of the proximal arteries, and improved cerebral microcirculation. The present study suggests that intra-arterial administration of fasudil hydrochloride is effective as a treatment for vasospasm following SAH.

Potent Vasodilatory Effect of Fasudil on Radial Artery Graft in Coronary Artery Bypass Operations

“…These results indicate a very potent vasodilatory effect of fasudil for the RA graft. Moreover, intraluminal administration of fasudil did not affect the hemodynamic parameters or cause adverse effects, which is consistent with previous report in patients with cerebral vasospasm after subarachnoid hemorrhage who received fasudil treatment [6]. In the present study the RA conduits remained dilated during CABG after short-term fasudil treatment.…”

“…Fasudil is a relatively low cost drug and has a long history of clinical use. The performance of this drug in the neurosurgical field has been documented for over 10 years [6]. Therefore fasudil can be used without concern over safety.…”

“…In this study, we investigated the effectiveness of a Rho-kinase inhibitor, fasudil, which is a vasodilator with a new mechanism of action. Due to its potent vasodilating action, fasudil has been used clinically in the field of neurosurgery to prevent cerebral vasospasm, a serious complication secondary to intracranial hemorrhage [6]. Through attenuating coronary spasm, the potential of fasudil in the treatment of heart disease and arteriosclerosis is also anticipated [7].…”

Fasudil Is a Superior Vasodilator for the Internal Thoracic Artery in Coronary Surgery

“…Fasudil is a relatively low cost drug and has a long history of clinical application. The performance of this drug in the neurosurgical field has been documented for over 10 years [6]. Therefore fasudil can be used without concern over safety.…”

“…In the field of neurosurgery, fasudil is a very effective drug for the prevention of cerebral vasospasm, which is a serious complication secondary to intracranial hemorrhage. 6 In cardiovascular field, fasudil attenuates coronary spasm, and its potential in the treatment of ischemic heart disease and arteriosclerosis is anticipated. 7 Focusing on the potent vasodilating action of this drug and considering its clinical safety, we examined the usefulness of fasudil as a vasodilating agent for ITA graft and compared with the conventionally used papaverine.…”