Continuous intravertebral injection of fasudil hydrochloride in the treatment of cerebral vasospasm

Background and Objective : Cerebral vasospasm is a serious complication of subarachnoid hemorrhage (SAH) and is associated with clinical deterioration and mortality. The objective of this study is to investigate the effect of continuous intravertebral artery (cIVA) injection of fasudil hydrochloride on delayed cerebral vasospasm (CVS).
Material and Methods : Forty white rabbits were alloted into groups: (i) seven-day (cIVA injection of fasudil hydrochloride for seven days after injection of blood) group, (ii) five-day (cIVA injection of fasudil hydrochloride for five days from the third day after injection of blood) group, (iii) intravenous treatment (intravenous infusion of fasudil hydrochloride after the first blood injection twice a day) group, and (iv) control group. All the rabbits in all the four groups underwent selective vertebrobasilar angiography. The pathological changes in the basal artery were observed by light and electron microscopy. Fasudil hydrochloride injection (2ml:30mg) was provided by Tianjin Chase Sun Pharmaceutical Company Limited.
Results : Severe CVS occurred after subarachnoid hemorrhage (SAH) in the control group, whereas, it was significantly lower after intravertebral artery and intravenous injection of fasudil hydrochloride. The difference between the intravenous and intravertebral artery groups was statistically significant on the seventh day.
Conclusions : The effect of cIVA injection of fasudil hydrochloride in treating delayed CVS due to SAH at different time points was better than intravenous administration.

Keywords
Cerebral vasospasm, continuous intravertebral artery injection, fasudil hydrochloride, subarachnoid hemorrhage