Cerebral venous circulation changes caused by aneurysmal subarachnoid hemorrhage

Wang, S; Li, B; Yin, Tengkun; Hong, Jeong Ho; Gu, Jianjun; Wei, Liangfeng

doi:10.3233/ch-190573

Cited by 3 publications

(5 citation statements)

References 36 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Investigations of aSAH showed that elevated cerebral blood ow velocity predicts vasospasm and delayed cerebral ischemia [32,33]. Especially in critically severe aSAH patients, prolonged cerebral circulation time (CCT) is related to the occurrence of CV [14]. The mechanism of cerebral vein circulation disorder involves elevated intracranial pressure and gradual brain tissue swelling leading to decreased blood ow from cortical veins [34], and impaired autoregulation of brain blood ow leading to arteriolar vasospasm and the formation of microthrombi [35].…”

Section: Discussionmentioning

confidence: 99%

“…Cerebral venous circulation time is de ned as the time required for blood to enter the venous sinus through the deep and super cial veins of the brain and then be drained into the jugular vein, including microvascular cerebral circulation time, venous cerebral circulation time, and the PRECISE score. Following S.Wang's research, the starting point T1 is set as the rst image in the sagittal view of digital subtraction angiography (DSA), which depicts the contrast dye within the branches of the middle cerebral cortical arteries [14]. The vein image that shows the peak lling of the parietal cortical vein is set as T2 and the only disappearance of the sigmoid sinus was set as T3.…”

Section: Primary and Secondary Outcomesmentioning

confidence: 99%

See 1 more Smart Citation

Effects of low-dose intravenous heparin therapy in aneurysmal subarachnoid hemorrhage: a randomized controlled clinical trial protocol

Zhang¹,

Hu²

2023

Preprint

View full text Add to dashboard Cite

Background Heparin anticoagulation therapy is a widely used method to prevent cerebral vasospasm (CV) and venous thrombosis in patients with subarachnoid hemorrhage caused by ruptured cerebral aneurysms. Subcutaneous heparin injection is considered safe and effective, whereas continuous intravenous heparin infusion is still being debated due to the risk of bleeding. Although most retrospective studies have confirmed the safety and effectiveness of unfractionated heparin (UFH) after aneurysm embolization therapy and its ability to reduce CV, there is still no randomized clinical trial comparing UFH and subcutaneous low-molecular-weight heparin (LMWH) injection in this population. This study aims to Therefore, this study aims to compare the clinical outcomes associated with these two treatment approaches. Methods The study is an open-label, single-center, randomized controlled trial and aims to recruit 456 patients, with 228 patients in each group. The primary outcome was CV, the second outcomes measures are occurrence of bleeding events, ischemic events, heparin-induced thrombocytopenia, deep vein thrombosis, cerebral venous circulation time, brain edema score, and hydrocephalus incidence. Ethics and dissemination: This study protocol obtained ethical approval from the Ethics Committee of Baoan People’s Hospital, Shenzhen, Guangdong (approval number: BYL20220805). This work will be published in peer-reviewed international medical journals and presented at medical conferences. ClinicalTrails ID: NCT05696639. Registered on March 30, 2023.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Primary and Secondary Outcomesmentioning

confidence: 99%

Effects of low-dose intravenous heparin therapy in aneurysmal subarachnoid hemorrhage: a randomized controlled clinical trial protocol

Zhang¹,

Hu²

2023

Preprint

View full text Add to dashboard Cite

show abstract

“… 7 - 9 It has been shown that the risk of vasospasm is significantly correlated with the amount of SAH, and erythrocyte degradation in the subarachnoid space synchronizes with the onset of vasospasm. 10 , 11 Thus, it is speculated that erythrocyte degradation products may be one of the inducing factors of vasospasm. In addition, some studies have pointed out that oxidized Hb, a degradation product of Hb, plays a major role in vasospasm.…”

Section: Discussionmentioning

confidence: 99%

“… 2 A survey shows that about 20%-40% SAH patients have vasospasm at different degrees, and CVS is also one of the important causes of stroke and even death. 3 How to effectively improve CVS after SAH is one of the hotspots and difficulties in current clinical research. Dextran, the α-1,6-linked glucose polymer widely used in biology and medicine, promises new applications.…”

Section: Introductionmentioning

confidence: 99%

Analysis on efficacy of compound dextran combined with atorvastatin calcium in patients with CVS caused by SAH based on TCD blood flow indexes

Ma¹,

Gan²,

Su³

et al. 2022

Pak J Med Sci

View full text Add to dashboard Cite

Objectives: To analyze the effects of compound dextran combined with atorvastatin calcium on blood flow indexes, peroxidase 2 (Prx2) and endothelin-1 (ET-1) in patients with cerebral vasospasm (CVS) caused by subarachnoid hemorrhage (SAH). Methods: One hundred patients with CVS caused by SAH treated in Baoding No.1 Central Hospital from January 2019 to December 2020 were divided into observation group and control group. The control group was treated with atorvastatin calcium tablets, while the observation group was additionally treated with compound dextran. The hospital stays, Glasgow Outcome Scale (GOS), hemoglobin (Hb) and hematocrit (Hct) levels before and five days after treatment were recorded. The hemodynamic parameters of the middle cerebral artery (MCA) and the serum levels of Prx2 and ET-1 were detected. Results: After treatment, GOS and Hct levels in the observation group were both higher than those in the control group (P < 0.05). After treatment, the mean and peak velocities of the MCA in the observation group were significantly lower than those in the control group (P < 0.05). After treatment, the serum levels of Prx2 and ET-1 in the observation group were significantly lower compared with those in the control group (P < 0.05). However, no significant differences were found in the incidences of adverse reactions between the two groups (P > 0.05). Conclusions: Compound dextran combined with atorvastatin calcium can effectively enhance clinical efficacy, improve cerebral blood flow and reduce serum Prx2 and ET-1 levels in patients with CVS caused by SAH. doi: https://doi.org/10.12669/pjms.38.8.5504 How to cite this:Zhang Y, Ma F, Gan N, Su F, Song Z. Analysis on efficacy of compound dextran combined with atorvastatin calcium in patients with CVS caused by SAH based on TCD blood flow indexes. Pak J Med Sci. 2022;38(8):---------. doi: https://doi.org/10.12669/pjms.38.8.5504 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

show abstract

“…Cerebral venous circulation time is defined as the time required for blood to enter the venous sinus through the deep and superficial veins of the brain and then be drained into the jugular vein, including microvascular cerebral circulation time, venous cerebral circulation time, and the PRECISE score. Following S. Wang’s research, the starting point T1 is set as the first image in the sagittal view of digital subtraction angiography (DSA), which depicts the contrast dye within the branches of the middle cerebral cortical arteries [ 19 ]. The vein image that shows the peak filling of the parietal cortical vein is set as T2, and the only disappearance of the sigmoid sinus was set as T3.…”

Section: Methodsmentioning

confidence: 99%

Effects of low-dose intravenous heparin therapy in aneurysmal subarachnoid hemorrhage: a randomized controlled clinical trial protocol

Zhang

2023

Trials

View full text Add to dashboard Cite

Background Heparin anticoagulation therapy is a widely used method to prevent cerebral vasospasm (CV) and venous thrombosis in patients with subarachnoid hemorrhage caused by ruptured cerebral aneurysms. Subcutaneous heparin injection is considered safe and effective, whereas continuous intravenous heparin infusion is still being debated due to the risk of bleeding. Although most retrospective studies have confirmed the safety and effectiveness of unfractionated heparin (UFH) after aneurysm embolization therapy and its ability to reduce CV, there is still no randomized clinical trial comparing UFH and subcutaneous low-molecular-weight heparin (LMWH) injection in this population. Therefore, this study aims to compare the clinical outcomes associated with these two treatment approaches. Methods The study is an open-label, single-center, randomized controlled trial and aims to recruit 456 patients, with 228 patients in each group. The primary outcome was CV; the second outcomes measures are occurrence of bleeding events, ischemic events, heparin-induced thrombocytopenia, deep vein thrombosis, cerebral venous circulation time, brain edema score, and hydrocephalus incidence. Ethics and dissemination This study protocol obtained ethical approval from the Ethics Committee of Baoan People’s Hospital, Shenzhen, Guangdong (approval number: BYL20220805). This work will be published in peer-reviewed international medical journals and presented at medical conferences. Trial registration ClinicalTrials ID: NCT05696639. Registered on March 30, 2023.

show abstract

Cerebral venous circulation changes caused by aneurysmal subarachnoid hemorrhage

Cited by 3 publications

References 36 publications

Effects of low-dose intravenous heparin therapy in aneurysmal subarachnoid hemorrhage: a randomized controlled clinical trial protocol

Effects of low-dose intravenous heparin therapy in aneurysmal subarachnoid hemorrhage: a randomized controlled clinical trial protocol

Analysis on efficacy of compound dextran combined with atorvastatin calcium in patients with CVS caused by SAH based on TCD blood flow indexes

Effects of low-dose intravenous heparin therapy in aneurysmal subarachnoid hemorrhage: a randomized controlled clinical trial protocol

Contact Info

Product

Resources

About