{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T14:32:15Z","timestamp":1787841135534,"version":"build-2784847793"},"reference-count":31,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","license":[{"start":{"date-parts":[[2025,9,23]],"date-time":"2025-09-23T00:00:00Z","timestamp":1758585600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>Abstract:<\/jats:title>\n                  <jats:sec>\n                    <jats:title>OBJECTIVE:<\/jats:title>\n                    <jats:p>Whether radiological cerebral vasospasm (CVS) should be proactively treated following subarachnoid hemorrhage to reduce the development of delayed cerebral ischemia (DCI) and brain infarction remains unclear. In this bicentric retrospective study, we sought to determine if a first-line intravenous therapy (IVT) to early detect and treat CVS could be noninferior on neurological outcomes to a first-line endovascular therapy (ET) requiring intra-arterial procedures for confirmed CVS as the reference approach.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>Two cohorts of unselected patients exposed to the risk of CVS were studied following coil embolization for ruptured intracranial aneurysms. In the IVT group, CVS was actively detected and treated using a continuous intravenous infusion of milrinone for at least 7 days. In the ET group, selective intra-arterial infusions of nimodipine and milrinone were performed to treat confirmed CVS, and repeated if necessary. The primary endpoint was the proportion of patients with a good functional neurological outcome at 12 months using the modified Rankin Scale 0\u20132, with a noninferiority margin of 15%.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>The good outcome of patients exposed to the risk of CVS was noninferior between the IVT and ET strategies: 108\/119 patients (91%; 95% confidence interval [CI] 84% to 95%) versus 77\/97 patients (79%; 95% CI: 70% to 87%), respectively. The IVT strategy led to the diagnosis of CVS in more patients in a shorter delay, and a reduced proportion of patients with DCI and brain infarction. There was no difference in the drug-related side effects between the two groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION:<\/jats:title>\n                    <jats:p>A proactive intravenous treatment with milrinone to treat CVS had noninferior functional outcome compared to endovascular treatment using the selective intra-arterial infusion of vasodilator drugs.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/bc.bc_17_25","type":"journal-article","created":{"date-parts":[[2025,9,23]],"date-time":"2025-09-23T10:00:30Z","timestamp":1758621630000},"page":"167-175","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Management of radiological cerebral vasospasm after coil embolization for ruptured intracranial aneurysms: A noninferiority bicentric cohort study"],"prefix":"10.4103","volume":"12","author":[{"given":"Olivier","family":"Vincent","sequence":"first","affiliation":[{"name":"Department of Anesthesiology and Critical Care, Grenoble Alpes University Hospital, Grenoble, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandre","family":"Parrin","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Critical Care, Rothschild Foundation Hospital, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariano","family":"Mascellino","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Critical Care, Grenoble Alpes University Hospital, Grenoble, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Corentin","family":"Leroy","sequence":"additional","affiliation":[{"name":"Department of Public Health, Clinical Investigation Center-Technological Innovation, Grenoble Alpes University Hospital, Univ. Grenoble Alpes, Inserm, Grenoble, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicolas","family":"Engrand","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Critical Care, Rothschild Foundation Hospital, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean-Francois","family":"Payen","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Critical Care, Grenoble Alpes University Hospital, Grenoble, France"},{"name":"Inserm, U1216, Grenoble Institut Neurosciences, University Grenoble Alpes, Grenoble, France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2025,9,23]]},"reference":[{"key":"R1-20260330","doi-asserted-by":"crossref","first-page":"846","DOI":"10.1016\/S0140-6736(22)00938-2","article-title":"Spontaneous subarachnoid haemorrhage","volume":"400","author":"Claassen","year":"2022","journal-title":"Lancet"},{"key":"R2-20260330","doi-asserted-by":"crossref","first-page":"211","DOI":"10.1007\/s12028-011-9605-9","article-title":"Critical care management of patients following aneurysmal subarachnoid hemorrhage: Recommendations from the Neurocritical Care Society's Multidisciplinary Consensus Conference","volume":"15","author":"Diringer","year":"2011","journal-title":"Neurocrit Care"},{"key":"R3-20260330","doi-asserted-by":"crossref","first-page":"1711","DOI":"10.1161\/STR.0b013e3182587839","article-title":"Guidelines for the management of aneurysmal subarachnoid hemorrhage: A guideline for healthcare professionals from the American Heart Association\/American Stroke Association","volume":"43","author":"Connolly","year":"2012","journal-title":"Stroke"},{"key":"R4-20260330","first-page":"e314","article-title":"2023 guideline for the management of patients with aneurysmal subarachnoid hemorrhage: A guideline from the American Heart Association\/American Stroke Association","volume":"54","author":"Hoh","year":"2023","journal-title":"Stroke"},{"key":"R5-20260330","doi-asserted-by":"crossref","first-page":"174","DOI":"10.1097\/WNP.0000000000000273","article-title":"The pathophysiology of delayed cerebral ischemia","volume":"33","author":"Foreman","year":"2016","journal-title":"J Clin Neurophysiol"},{"key":"R6-20260330","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1186\/s13054-016-1193-9","article-title":"The critical care management of poor-grade subarachnoid haemorrhage","volume":"20","author":"de Oliveira Manoel","year":"2016","journal-title":"Crit Care"},{"key":"R7-20260330","doi-asserted-by":"crossref","first-page":"308","DOI":"10.1007\/s12028-011-9586-8","article-title":"Participants in the International Multi-Disciplinary Consensus Conference on the Critical Care Management of Subarachnoid Hemorrhage. Vasospasm versus delayed cerebral ischemia as an outcome event in clinical trials and observational studies","volume":"15","author":"Vergouwen","year":"2011","journal-title":"Neurocrit Care"},{"key":"R8-20260330","doi-asserted-by":"crossref","first-page":"618","DOI":"10.1016\/S1474-4422(11)70108-9","article-title":"Clazosentan, an endothelin receptor antagonist, in patients with aneurysmal subarachnoid haemorrhage undergoing surgical clipping: A randomised, double-blind, placebo-controlled phase 3 trial (CONSCIOUS-2)","volume":"10","author":"Macdonald","year":"2011","journal-title":"Lancet Neurol"},{"key":"R9-20260330","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1161\/STROKEAHA.114.007470","article-title":"Effects of prostacyclin on cerebral blood flow and vasospasm after subarachnoid hemorrhage: Randomized, pilot trial","volume":"46","author":"Rasmussen","year":"2015","journal-title":"Stroke"},{"key":"R10-20260330","doi-asserted-by":"crossref","first-page":"2723","DOI":"10.1007\/s00701-021-04935-8","article-title":"Intensive therapies of delayed cerebral ischemia after subarachnoid hemorrhage:A propensity-matched comparison of different center-driven strategies","volume":"163","author":"Labeyrie","year":"2021","journal-title":"Acta Neurochir (Wien)"},{"key":"R11-20260330","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1159\/000445509","article-title":"Effect of cilostazol on cerebral vasospasm and outcome in patients with aneurysmal subarachnoid hemorrhage: A randomized, double-blind, placebo-controlled trial","volume":"42","author":"Matsuda","year":"2016","journal-title":"Cerebrovasc Dis"},{"key":"R12-20260330","doi-asserted-by":"crossref","first-page":"354","DOI":"10.1007\/s12028-012-9701-5","article-title":"Milrinone and homeostasis to treat cerebral vasospasm associated with subarachnoid hemorrhage: The Montreal Neurological Hospital protocol","volume":"16","author":"Lannes","year":"2012","journal-title":"Neurocrit Care"},{"key":"R13-20260330","doi-asserted-by":"crossref","first-page":"323","DOI":"10.1097\/ANA.0000000000000527","article-title":"Which protocol for milrinone to treat cerebral vasospasm associated with subarachnoid hemorrhage?","volume":"31","author":"Crespy","year":"2019","journal-title":"J Neurosurg Anesthesiol"},{"key":"R14-20260330","doi-asserted-by":"crossref","first-page":"971","DOI":"10.3171\/2020.1.JNS193107","article-title":"Milrinone for refractory cerebral vasospasm with delayed cerebral ischemia","volume":"134","author":"Abulhasan","year":"2021","journal-title":"J Neurosurg"},{"key":"R15-20260330","doi-asserted-by":"crossref","first-page":"195","DOI":"10.1097\/ANA.0000000000000755","article-title":"Treatment of subarachnoid hemorrhage-associated delayed cerebral ischemia with milrinone: A review and proposal","volume":"33","author":"Bernier","year":"2021","journal-title":"J Neurosurg Anesthesiol"},{"key":"R16-20260330","first-page":"101192","article-title":"The French clinical research in the European Community regulation era","volume":"42","author":"Toulouse","year":"2023","journal-title":"Anaesth Crit Care Pain Med"},{"key":"R17-20260330","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1007\/s12028-023-01713-5","article-title":"Guidelines for the neurocritical care management of aneurysmal subarachnoid hemorrhage","volume":"39","author":"Treggiari","year":"2023","journal-title":"Neurocrit Care"},{"key":"R18-20260330","doi-asserted-by":"crossref","first-page":"2391","DOI":"10.1161\/STROKEAHA.110.589275","article-title":"Definition of delayed cerebral ischemia after aneurysmal subarachnoid hemorrhage as an outcome event in clinical trials and observational studies: Proposal of a multidisciplinary research group","volume":"41","author":"Vergouwen","year":"2010","journal-title":"Stroke"},{"key":"R19-20260330","first-page":"CD003085","article-title":"Endovascular coiling versus neurosurgical clipping for people with aneurysmal subarachnoid haemorrhage","volume":"8","author":"Lindgren","year":"2018","journal-title":"Cochrane Database Syst Rev"},{"key":"R20-20260330","doi-asserted-by":"crossref","first-page":"809","DOI":"10.1016\/S0140-6736(05)67214-5","article-title":"International Subarachnoid Aneurysm Trial (ISAT) of neurosurgical clipping versus endovascular coiling in 2143 patients with ruptured intracranial aneurysms: A randomised comparison of effects on survival, dependency, seizures, rebleeding, subgroups, and aneurysm occlusion","volume":"366","author":"Molyneux","year":"2005","journal-title":"Lancet"},{"key":"R21-20260330","doi-asserted-by":"crossref","first-page":"998","DOI":"10.1016\/S0140-6736(19)30297-1","article-title":"Aspiration thrombectomy versus stent retriever thrombectomy as first-line approach for large vessel occlusion (COMPASS): A multicentre, randomised, open label, blinded outcome, non-inferiority trial","volume":"393","author":"Turk","year":"2019","journal-title":"Lancet"},{"key":"R22-20260330","doi-asserted-by":"crossref","first-page":"1993","DOI":"10.1161\/STROKEAHA.121.035699","article-title":"Prophylactic therapies for morbidity and mortality after aneurysmal subarachnoid hemorrhage: A systematic review and network meta-analysis of randomized trials","volume":"53","author":"Dayyani","year":"2022","journal-title":"Stroke"},{"key":"R23-20260330","doi-asserted-by":"crossref","first-page":"3107","DOI":"10.1007\/s10143-021-01509-1","article-title":"Intravenous milrinone for treatment of delayed cerebral ischaemia following subarachnoid haemorrhage: A pooled systematic review","volume":"44","author":"Castle-Kirszbaum","year":"2021","journal-title":"Neurosurg Rev"},{"key":"R24-20260330","doi-asserted-by":"crossref","first-page":"220","DOI":"10.1186\/cc5958","article-title":"Clinical review: Prevention and therapy of vasospasm in subarachnoid hemorrhage","volume":"11","author":"Keyrouz","year":"2007","journal-title":"Crit Care"},{"key":"R25-20260330","first-page":"1778","article-title":"Predictors of outcome after endovascular treatment of cerebral vasospasm","volume":"25","author":"Rabinstein","year":"2004","journal-title":"Am J Neuroradiol"},{"key":"R26-20260330","doi-asserted-by":"crossref","first-page":"669","DOI":"10.1007\/s12028-021-01331-z","article-title":"Intravenous milrinone for cerebral vasospasm in subarachnoid hemorrhage: The MILRISPASM controlled before-after study","volume":"35","author":"Lakhal","year":"2021","journal-title":"Neurocrit Care"},{"key":"R27-20260330","first-page":"819","article-title":"Preliminary experience with intra-arterial nicardipine as a treatment for cerebral vasospasm","volume":"25","author":"Badjatia","year":"2004","journal-title":"Am J Neuroradiol"},{"key":"R28-20260330","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1016\/j.neurad.2018.04.001","article-title":"Complication rate of intraarterial treatment of severe cerebral vasospasm after subarachnoid hemorrhage with nimodipine and percutaneous transluminal balloon angioplasty: Worth the risk?","volume":"46","author":"Adami","year":"2019","journal-title":"J Neuroradiol"},{"key":"R29-20260330","doi-asserted-by":"crossref","first-page":"6197","DOI":"10.3390\/jcm11206197","article-title":"Invasive diagnostic and therapeutic management of cerebral Vasospasm after aneurysmal subarachnoid hemorrhage (IMCVS)-A phase 2 randomized controlled trial","volume":"11","author":"Vatter","year":"2022","journal-title":"J Clin Med"},{"key":"R30-20260330","doi-asserted-by":"crossref","first-page":"1130","DOI":"10.1136\/neurintsurg-2021-018117","article-title":"Comparing the efficacy and safety of the Skyflow device with those of the Solitaire FR stent in patients with acute ischemic stroke: A prospective, multicenter, randomized, non-inferiority clinical trial","volume":"14","author":"Zhou","year":"2022","journal-title":"J Neurointerv Surg"},{"key":"R31-20260330","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1186\/s12883-024-03567-6","article-title":"Study on prognosis of acutely ruptured intracranial aneurysms (SPARTA): A protocol for a multicentre prospective cohort study","volume":"24","author":"Hamming","year":"2024","journal-title":"BMC Neurol"}],"container-title":["Brain Circulation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/bc.bc_17_25","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T13:43:13Z","timestamp":1787838193000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/bc.bc_17_25"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,23]]},"references-count":31,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2026]]}},"URL":"https:\/\/doi.org\/10.4103\/bc.bc_17_25","relation":{},"ISSN":["2394-8108","2455-4626"],"issn-type":[{"value":"2394-8108","type":"print"},{"value":"2455-4626","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,23]]},"assertion":[{"value":"2025-01-26","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-04-10","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}