Evaluating Continuous Milrinone-Based Endovascular Therapy Compared to Standard Medical Management for Cerebral Vasospasm After Aneurysmal Subarachnoid Hemorrhage

What this Trial Is About

Cerebral vasospasm is a serious complication that can occur after aneurysmal subarachnoid hemorrhage and often leads to delayed cerebral ischemia and poor neurological outcomes. Effective treatments for this condition remain limited despite standard medical care. This trial is a multicenter, prospective, randomized controlled study aiming to evaluate whether early continuous milrinone-based endovascular therapy can improve outcomes in patients experiencing cerebral vasospasm after aneurysmal subarachnoid hemorrhage. Participants will be randomly assigned to one of two groups. The control group will receive standardized medical management including oral or enteral nimodipine, fluid and blood pressure management, and other supportive treatments. The experimental group will receive the same standardized care plus continuous milrinone-based endovascular therapy. This includes intra-arterial milrinone infusion into the affected artery, possible mechanical angioplasty if needed, followed by a 72-hour intravenous milrinone infusion. The dosing may be repeated if vasospasm recurs. Participants will be monitored for neurological function prognosis up to 90 days after randomization. Additional assessments include delayed cerebral ischemia, vasospasm resolution, clinical condition severity, cognitive function measured by the Montreal Cognitive Assessment, quality of life via the EuroQol 5-Dimension questionnaire, hospitalization costs, and length of hospital and ICU stays. The studys total duration extends up to the end date in 2029, with ongoing evaluations and follow-ups during this period.

Endovascular Therapy for Cerebral Vasospasm After Aneurysmal Subarachnoid Hemorrhage