Inhaled Nitric Oxide Treatment for Aneurysmal SAH Patients With Intractable Cerebral Vasospasm

• Status: Completed
• Trial end date: 2020-03-20
• Target enrollment: 0
• Participant gender: All

Summary

Aneurysmal subarachnoid haemorrhage (aSAH) is a rare but severe subtype of stroke with high mortality and morbidity. Besides rebleeding, delayed cerebral ischaemia and cerebral vasospasm (CVS) are thought to be major reasons for the poor outcome in survivors of aSAH. Despite advances in the detection and treatment of CVS 20-40% of CVS patients experience cerebral Ischaemia. Experimental animal studies for ischaemic stroke, traumatic brain injury, and SAH showed that inhaled nitric oxide (iNO) selectively dilates cerebral arteries and arterioles in hypoperfused brain tissue. The investigators therefore performed this prospective pilot study to evaluate the effects of iNO on cerebral perfusion in patients with refractory vasospasm after aSAH.

• Phase: N/A
• Accepts Healthy Volunteers?: No

Details

• Lead Sponsor: University Hospital Inselspital, Berne
• Treatments: Nitric Oxide

Criteria

Inclusion Criteria:

• aSAH of all severities

• Aneurysm treated by either surgical clipping or endovascular coiling

• Age between 18 - 80 years

• Proven CVS

• Cerebral hypoperfusion and neurological deficit despite treatment (oral nimodipine, induced hypertension, hypervolaemia, central venous pressure > 6 mmHg)

• A negative pregnancy test in women

• Signed informed consent from the next of kin and an independent physician

Exclusion Criteria:

• Unsecured aneurysm

• Cerebral infarction on imaging in the downstream brain parenchyma of spastic vessel

• Cerebral herniation

• Intracranial pressure > 25 mmHg

• Pregnancy

• Mean arterial pressure ≤ 90 mmHg despite catecholamines