Effect of selective inhibitor of thromboxane A2 synthetase on cerebral vasospasm after early surgery

Abstract

✓ The authors report the results of inhibition of thromboxane A 2 synthetase in 49 consecutive patients with subarachnoid hemorrhage (SAH). These unselected Grade I to IV patients all had a ruptured aneurysm of the anterior circle of Willis, and were operated on within 72 hours after SAH. Twenty-seven patients were treated postoperatively by an intravenous infusion of sodium(E)-3-[4-(3-pyridylmethyl)-phenyl]-2-propenoate (OKY-1581), a selective inhibitor of thromboxane A2 synthetase, at 5 µg/kg/min for 10 to 14 days, and the remaining 22 patients did not receive this drug. Both groups of patients had similar age distribution and preoperative neurological conditions. A suggestive but statistically insignificant improvement was found in postoperative angiographic vasospasm, ischemic symptoms, and overall outcome in the group receiving OKY-1581. The incidence of low-density areas on the postoperative computerized tomography scans was significantly decreased in patients treated with OKY-1581 infusion.