{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T19:47:16Z","timestamp":1792871236059,"version":"4.5.0"},"reference-count":30,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2025,11,21]],"date-time":"2025-11-21T00:00:00Z","timestamp":1763683200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/501100001691","name":"japan society for the promotion of science","doi-asserted-by":"publisher","award":["23K08536"],"award-info":[{"award-number":["23K08536"]}],"id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Cereb Blood Flow Metab"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:p>\n                    There are conflicting results regarding the efficacy of clazosentan, a selective endothelin A receptor antagonist, on cerebral vasospasm after subarachnoid hemorrhage (SAH). As the effectiveness of clazosentan for patients over 75 years old and those with World Federation of Neurosurgical Societies grade V has not been established, we aimed to evaluate its efficacy in real-world clinical settings. This study utilized prospectively collected data from consecutive SAH patients across 4 stroke centers, comparing 187 patients treated with clazosentan to 223 patients receiving standard of care. The incidence of favorable functional outcomes (modified Rankin Scale score 0\u20132) at 90 days after SAH, occurred more frequently in patients receiving clazosentan (74.9% vs 65.0%,\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    = 0.032). Multiple logistic analyses identified clazosentan administration as independently associated with favorable functional outcomes (49.1% vs 37.6%, odds ratio 2.17 [1.22\u20133.85],\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    = 0.008). Angiographic vasospasm (25.7% vs 48.9%,\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    &lt; 0.001) and vasospasm-related infarcts (11.8% vs 20.2%,\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    = 0.023) were less frequent among patients receiving clazosentan. Stratification analyses revealed that clazosentan usage increased the incidence of favorable functional outcomes regardless of age, sex, SAH severity, and clot volume. These results underscore the therapeutic potential of clazosentan against cerebral vasospasm independent of patient characteristics.\n                  <\/jats:p>","DOI":"10.1177\/0271678x251399068","type":"journal-article","created":{"date-parts":[[2025,11,22]],"date-time":"2025-11-22T04:41:16Z","timestamp":1763786476000},"page":"843-851","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":9,"title":["Stratified assessment of clazosentan efficacy following subarachnoid hemorrhage: A multi-center cohort study"],"prefix":"10.1177","volume":"46","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0745-9538","authenticated-orcid":false,"given":"Hiroyuki","family":"Sakata","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Tohoku University Graduate School of Medicine, Sendai, Japan"},{"name":"Department of Neurosurgery, Kohnan Hospital, Sendai, Japan"},{"name":"Department of Neuroendovascular Therapy, Kohnan Hospital, Sendai, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroki","family":"Uchida","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Kohnan Hospital, Sendai, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Atsushi","family":"Kanoke","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Kohnan Hospital, Sendai, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shunsuke","family":"Omodaka","sequence":"additional","affiliation":[{"name":"Department of Neuroendovascular Therapy, Kohnan Hospital, Sendai, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1099-303X","authenticated-orcid":false,"given":"Ryosuke","family":"Tashiro","sequence":"additional","affiliation":[{"name":"Department of Neuroendovascular Therapy, Kohnan Hospital, Sendai, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshimichi","family":"Sato","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Kohnan Hospital, Sendai, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naoto","family":"Kimura","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Iwate Prefectural Central Hospital, Morioka, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masahiro","family":"Yoshida","sequence":"additional","affiliation":[{"name":"Preemptive Medicine in the Community of the North Miyagi (Osaki Citizen Hospital), Tohoku University Graduate School of Medicine, Sendai, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenichi","family":"Sato","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, National Hospital Organization Sendai Medical Center, Sendai, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kuniyasu","family":"Niizuma","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Tohoku University Graduate School of Medicine, Sendai, Japan"},{"name":"Department of Neurosurgical Engineering, Graduate School of Biomedical Engineering, Tohoku University, Sendai, Japan"},{"name":"Department of Translational Neuroscience, Tohoku University Graduate School of Medicine, Sendai, Japan"},{"name":"Research Division of Advanced Diagnosis and Treatment for Subarachnoid Hemorrhage, Tohoku University Hospital, Sendai, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hirohito","family":"Metoki","sequence":"additional","affiliation":[{"name":"Division of Public Health, Hygiene and Epidemiology, Faculty of Medicine, Tohoku Medical and Pharmaceutical University, Sendai, Japan"},{"name":"Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hidenori","family":"Endo","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Tohoku University Graduate School of Medicine, Sendai, Japan"},{"name":"Research Division of Advanced Diagnosis and Treatment for Subarachnoid Hemorrhage, Tohoku University Hospital, Sendai, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,11,21]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10143-006-0045-5"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198303173081103"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.50.4.876"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10143-024-02543-5"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1161\/STR.0b013e3182587839"},{"issue":"5","key":"e_1_3_3_7_2","first-page":"906","article-title":"[Postoperative management of aneurysmal subarachnoid hemorrhage]","volume":"52","author":"Sakata H","year":"2024","unstructured":"Sakata H, Endo H. [Postoperative management of aneurysmal subarachnoid hemorrhage]. No Shinkei Geka 2024; 52(5): 906\u2013913.","journal-title":"No Shinkei Geka"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1038\/332411a0"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.3389\/fphar.2020.628956"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1227\/neu.0000000000002601"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1159\/000475824"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(11)70108-9"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.111.648980"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.108.519942"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.3171\/2022.2.JNS212914"},{"key":"e_1_3_3_16_2","first-page":"98","article-title":"REACT: a randomized trial to assess the efficacy and safety of clazosentan for preventing clinical deterioration due to delayed cerebral ischemia after aneurysmal subarachnoid hemorrhage","volume":"142","author":"Mayer SA","year":"2024","unstructured":"Mayer SA, Bruder N, Citerio G, et al. REACT: a randomized trial to assess the efficacy and safety of clazosentan for preventing clinical deterioration due to delayed cerebral ischemia after aneurysmal subarachnoid hemorrhage. J Neurol Surg 2024; 142: 98\u2013109.","journal-title":"J Neurol Surg"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2024.1413632"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.3171\/jns.1992.76.4.0571"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.3171\/2012.9.JNS12492"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.1124\/jpet.116.234930"},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.wneu.2019.04.222"},{"key":"e_1_3_3_22_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11883-017-0690-x"},{"key":"e_1_3_3_23_2","doi-asserted-by":"publisher","DOI":"10.1038\/nrneurol.2013.246"},{"key":"e_1_3_3_24_2","doi-asserted-by":"publisher","DOI":"10.3171\/2023.3.JNS222720"},{"key":"e_1_3_3_25_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13054-016-1193-9"},{"issue":"6","key":"e_1_3_3_26_2","first-page":"359","article-title":"Safety and efficacy of clazosentan sodium (PIVLAZ\u24c7 Intravenous Solution 150 mg) in postoperative patients with subarachnoid hemorrhage due to cerebral aneurysm: interim analysis of the post-marketing survey in Japan","volume":"61","author":"Fujimoto N","year":"2024","unstructured":"Fujimoto N, Takeyama K, Aikawa Y, et al. Safety and efficacy of clazosentan sodium (PIVLAZ\u24c7 Intravenous Solution 150 mg) in postoperative patients with subarachnoid hemorrhage due to cerebral aneurysm: interim analysis of the post-marketing survey in Japan. Med Consult N Remed 2024; 61(6): 359\u2013377.","journal-title":"Med Consult N Remed"},{"key":"e_1_3_3_27_2","doi-asserted-by":"publisher","DOI":"10.3390\/medicina60010185"},{"key":"e_1_3_3_28_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.119.027424"},{"key":"e_1_3_3_29_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2023.1792"},{"key":"e_1_3_3_30_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000007862"},{"key":"e_1_3_3_31_2","doi-asserted-by":"publisher","DOI":"10.1161\/STR.0000000000000436"}],"container-title":["Journal of Cerebral Blood Flow &amp; Metabolism"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0271678X251399068","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/0271678X251399068","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0271678X251399068","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T11:11:02Z","timestamp":1782385862000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/0271678X251399068"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,21]]},"references-count":30,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2026,4]]}},"alternative-id":["10.1177\/0271678X251399068"],"URL":"https:\/\/doi.org\/10.1177\/0271678x251399068","relation":{},"ISSN":["0271-678X","1559-7016"],"issn-type":[{"value":"0271-678X","type":"print"},{"value":"1559-7016","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,21]]}}}