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1000 Titel
  • Stereotactic cisternal lavage in patients with aneurysmal subarachnoid hemorrhage with urokinase and nimodipine for the prevention of secondary brain injury (SPLASH): study protocol for a randomized controlled trial
1000 Autor/in
  1. Roelz, Roland |
  2. Schubach, Fabian |
  3. Coenen, Volker A. |
  4. Jenkner, Carolin |
  5. Scheiwe, Christian |
  6. Grauvogel, Jürgen |
  7. Niesen, Wolf-Dirk |
  8. Urbach, Horst |
  9. Taschner, Christian |
  10. Seufert, Jochen |
  11. Kätzler, Jürgen |
  12. Beck, Jürgen |
  13. Reinacher, Peter C. |
1000 Erscheinungsjahr 2021
1000 Publikationstyp
  1. Artikel |
1000 Online veröffentlicht
  • 2021-04-15
1000 Erschienen in
1000 Quellenangabe
  • 22(1):285
1000 Copyrightjahr
  • 2021
1000 Lizenz
1000 Verlagsversion
  • https://doi.org/10.1186/s13063-021-05208-6 |
  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8048077/ |
1000 Publikationsstatus
1000 Sprache der Publikation
1000 Abstract/Summary
  • Background!#!Delayed cerebral infarction (DCI) is a major cause of death and poor neurological outcome in patients with aneurysmal subarachnoid hemorrhage (aSAH). Direct intrathecal therapies with fibrinolytic and spasmolytic drugs have appeared promising in clinical trials. However, access to the subarachnoid space for intrathecal drug administration is an unsolved problem so far, especially in patients with endovascular aneurysm securing. We investigate a therapy protocol based on stereotactic catheter ventriculocisternostomy (STX-VCS), a new approach to overcome this problem. The primary objective of this study is to assess whether cisternal lavage with urokinase, nimodipine, and Ringer's solution administered via a stereotactically implanted catheter into the basal cisterns (= investigational treatment (IT)) is safe and improves neurological outcome in patients with aSAH.!##!Methods!#!This is a randomized, controlled, parallel-group, open-label phase II trial. Fifty-four patients with severe aSAH (WFNS grade ≥ 3) will be enrolled at one academic tertiary care center in Southern Germany. Patients will be randomized at a ratio of 1:1 to receive either standard of care only or standard of care plus the IT. The primary endpoint is the proportion of subjects with a favorable outcome on the Modified Rankin Scale (defined as mRS 0-3) at 6 months after aSAH. Further clinical and surrogate outcome parameters are defined as secondary endpoints.!##!Discussion!#!New approaches for the prevention and therapy of secondary brain injury in patients with aSAH are urgently needed. We propose this RCT to assess the clinical safety and efficacy of a novel therapy protocol for intrathecal administration of urokinase, nimodipine, and Ringer's solution.!##!Trial registration!#!Deutsches Register Klinischer Studien (German Clinical Trials Register), DRKS00015645 . Registered on 8 May 2019.
1000 Sacherschließung
lokal Aortic Aneurysm, Abdominal [MeSH]
lokal Nimodipine
lokal Urokinase
lokal Study Protocol
lokal Humans [MeSH]
lokal Urokinase-Type Plasminogen Activator [MeSH]
lokal Treatment Outcome [MeSH]
lokal Subarachnoid Hemorrhage/diagnosis [MeSH]
lokal Brain Injuries [MeSH]
lokal Nimodipine [MeSH]
lokal Randomized Controlled Trials as Topic [MeSH]
lokal Aneurysmal subarachnoid hemorrhage (aSAH)
lokal Delayed cerebral infarction (DCI)
lokal Intrathecal treatment
lokal Germany [MeSH]
lokal Clinical trial
lokal Intracisternal lavage
lokal Stereotactic ventriculocisternostomy (STX-VCS)
lokal Therapeutic Irrigation [MeSH]
lokal Blood Vessel Prosthesis Implantation [MeSH]
lokal Endovascular Procedures [MeSH]
1000 Liste der Beteiligten
  1. https://frl.publisso.de/adhoc/uri/Um9lbHosIFJvbGFuZA==|https://orcid.org/0000-0002-9387-019X|https://frl.publisso.de/adhoc/uri/Q29lbmVuLCBWb2xrZXIgQS4=|https://frl.publisso.de/adhoc/uri/SmVua25lciwgQ2Fyb2xpbg==|https://frl.publisso.de/adhoc/uri/U2NoZWl3ZSwgQ2hyaXN0aWFu|https://frl.publisso.de/adhoc/uri/R3JhdXZvZ2VsLCBKw7xyZ2Vu|https://frl.publisso.de/adhoc/uri/Tmllc2VuLCBXb2xmLURpcms=|https://frl.publisso.de/adhoc/uri/VXJiYWNoLCBIb3JzdA==|https://frl.publisso.de/adhoc/uri/VGFzY2huZXIsIENocmlzdGlhbg==|https://frl.publisso.de/adhoc/uri/U2V1ZmVydCwgSm9jaGVu|https://frl.publisso.de/adhoc/uri/S8OkdHpsZXIsIErDvHJnZW4=|https://frl.publisso.de/adhoc/uri/QmVjaywgSsO8cmdlbg==|https://frl.publisso.de/adhoc/uri/UmVpbmFjaGVyLCBQZXRlciBDLg==
1000 Hinweis
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1000 Erstellt am 2023-11-16T14:21:51.682+0100
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