Initial Treatment Experience with Clazosentan for Cerebral Vasospasm after Subarachnoid Hemorrhage

Abstract

Clazosentan is used to suppress the onset of cerebral vasospasm, delayed cerebral ischemia (DCI), and new cerebral infarctions after subarachnoid hemorrhage. Here we retrospectively examine our initial experience using this drug in our department. Evaluation items included patient background factors, clinical characteristics, spasms on imaging, DCI/new cerebral infarction, complications associated with fluid retention, and other complications. Thirty-two patients were included; among them, clazosentan was administered to 25. In the clazosentan group, 10 patients (31%) exhibited spasms on imaging, one (4%) experienced DCI, and four (16%) had a new cerebral infarction. Complications associated with fluid retention occurred in 13 patients (52%). Although differences were observed in the phase III study in patient background factors, clinical characteristics, and concomitant medications, clazosentan effectively prevented DCI and new cerebral infarctions. Additional cases should be examined to establish an ideal body fluid management protocol.