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A trial of cerebral angioplasty for post-subarachnoid haemorrhage symptomatic vasospasm

Not Applicable
Completed
Conditions
Symptomatic vasospasm post-aneurysmal subarachnoid haemorrhage
Circulatory System
Cerebrovasular diseases
Registration Number
ISRCTN18815770
Lead Sponsor
othian University Hospitals Division (UK)
Brief Summary

Not available

Detailed Description

Not available

Recruitment & Eligibility

Status
Completed
Sex
All
Target Recruitment
200
Inclusion Criteria

1. Have a documented SAH from a ruptured aneurysm
2. Ruptured aneurysm must be secured by coiling or clipping
3. Patients have developed a delayed ischaemic neurological deficit, this is defined as any one of:
3.1. Clear focal neurological deficit developing after 72 hours post ictus
3.2. Falling Glasgow Coma Score (GCS) by two or more points after 72 hours post ictus
3.3. Increasingly severe headache after 72 hours post ictus with confirmation of angiographic vasospasm
For points a + b clinical suspicion of symptomatic vasospasm should be confirmed where possible by imaging demonstration of vasospasm (this can be by any standard technique: Angiography, Trans-Cranial Doppler sonography (TCD), Single Photon Emission Computerised Tomography (SPECT), CT or Magnetic Resonance (MR) angio/perfusion)
4. Informed consent/assent in line with local and multicentre ethics approval
5. Rebleeding and hydrocephalus have been excluded on Computerised Tomography (CT) brain scan
6. Availability of CBA within 24 hours of DIND symptom onset (aim is to perform CBA as soon as possible after onset of symptomatic vasospasm - timing related to symptom onset will be recorded)

Exclusion Criteria

1. Consent unobtainable from patient (World Federation of Neurosurgical Sciences [WFNS] grade four or five, or grade three but dysphasic) or no personal or professional legal representative available to assent on their behalf
2. Another cause for deterioration/ischaemic deficit demonstrated
3. Participation in another clinical neurointerventional trial related to the management of ASAH
4. Pregnancy is also an exclusion criterion

Study & Design

Study Type
Interventional
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
Death/disability at three months as assessed by Modified Rankin Score (MRS) and National Institute of Health Stroke Scale (NIHSS) determined by independent 'blinded' neurologist
Secondary Outcome Measures
NameTimeMethod
1. Clinical outcome at one year (MRS & Euroquol instrument assessment)<br>2. Duration of stay in Intensive Care Unit (ICU)/hospital<br>3. Discharge destination<br>4. Requirement for extended care facilities<br>5. Cost assessment of CBA versus control group
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