Pharmacologic reduction of angiographic vasospasm in experimental subarachnoid hemorrhage: systematic review.

Tommaso Zoerle, Don Ilodigwe, Hoyee Wan, Katarina Lakovic, Mohammed Sabri, Jinglu Ai, R Loch Macdonald

Department of Anesthesia and Critical Care Medicine, University of Milano, Milan, Italy.

Acta neurochirurgica. Supplement 2013

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Animal models have been developed to simulate angiographic vasospasm secondary to subarachnoid hemorrhage (SAH) and to test pharmacologic treatments. Our aim was to evaluate the effect of pharmacologic treatments that have been tested in humans and in preclinical studies to determine if animal models inform results reported in humans. A systematic review and meta-analysis of SAH studies was performed. We investigated predictors of -translation from animals to humans with multivariate logistic regression. Pharmacologic reduction of vasospasm was effective in mice, rats, rabbits, dogs, nonhuman primates, and humans. Animal studies were generally of poor methodologic quality, and there was evidence of publication bias. Fresh blood injection to simulate SAH (vs. clot placement) and evaluation of vasospasm more than 3 days after SAH were independently associated with successful translation. We conclude that reduction of vasospasm is effective in animals and humans, and that injection of fresh blood and evaluation of vasospasm more than 3 days after SAH may be preferable for preclinical models.

Citation

Tommaso Zoerle, Don Ilodigwe, Hoyee Wan, Katarina Lakovic, Mohammed Sabri, Jinglu Ai, R Loch Macdonald. Pharmacologic reduction of angiographic vasospasm in experimental subarachnoid hemorrhage: systematic review. Acta neurochirurgica. Supplement. 2013;115:247-51