gms | German Medical Science

57th Annual Meeting of the German Society of Neurosurgery
Joint Meeting with the Japanese Neurosurgical Society

German Society of Neurosurgery (DGNC)

11 - 14 May, Essen

Minor edema formation after DSPA-induced clot lysis of experimental intracerebral hemorrhages

Verminderte Ödementwicklung nach DSPA-induzierter Lysetherapie experimenteller intrazerebraler Blutungen

Meeting Abstract

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  • corresponding author R. Thiex - Neurochirurgische Klinik, Universitätsklinikum Aachen
  • O. Schwartz - Neurochirurgische Klinik, Universitätsklinikum Aachen
  • T. Krings - Abteilung für Neuroradiologie, Universitätsklinikum Aachen
  • V. Rohde - Neurochirurgische Klinik, Universitätsklinikum Aachen

Deutsche Gesellschaft für Neurochirurgie. Japanische Gesellschaft für Neurochirurgie. 57. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie. Essen, 11.-14.05.2006. Düsseldorf, Köln: German Medical Science; 2006. DocP 10.152

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/dgnc2006/06dgnc369.shtml

Published: May 8, 2006

© 2006 Thiex et al.
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Outline

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Objective: Since Desmoteplase (DSPA) differs from recombinant tissue plasminogen activator (rtPA) in its higher fibrinogen affinity and absence of excitotoxicity, we regarded it as a key candidate for local fibrinolysis of experimental intracerebral hemorrhages.

Methods: In 17 pigs with a body weight of 30-35 kg, a balloon was inflated in the right frontal white matter to create a preformed cavity. Subsequently, autologous venous blood was injected ICP-controlled via a 1.2 cm-long catheter attached to a subgaleal Rickham reservoir. After MR imaging, DSPA (n=7) or rtPA (n=4) were injected in equimolar concentrations into the hematoma immediately after hematoma induction. In 6 control pigs, the hematoma was not treated at all. For hematoma and edema quantitation, MR imaging was repeated using T2* weighted and FLAIR sequences 4 and 10 days after hematoma induction.

Results: In the 6 DSPA-treated pigs, the hematoma significantly reduced from 1.36±0.45 cm3 to 0.43±0.37 cm3 (p<0.02) and the increase in edema size from 0.92±0.78 cm3 to 1.01±1.7 cm3 within 10 days was not significant as opposed to both the rtPA-treated and control pigs. The inflammatory reactions measured on EvG-stained slices was significantly less in DSPA-treated pigs compared with rtPA-treated pigs.

Conclusions: Local administration of DSPA exerts a minor degree of edema formation and inflammatory reactions in pigs with intracerebral hemorrhages. For its lacking excitotoxic properties, DSPA appears favourable to rtPA in local clot lysis.