Impact of a Protocol for Acute Antifibrinolytic Therapy on Aneurysm Rebleeding After Subarachnoid Hemorrhage

• DOI: 10.1161/strokeaha.107.506097
• Publication Date: 2008-07-25T02:01:12Z
• Authors: Robert M. Starke; Grace H. Kim; Andres Fernandez; Ricardo J. Komotar; Zachary L. Hickman; Marc L. Otten; Andrew F. Ducruet; Christopher P. Ke...; David K. Hahn; Markus Chwajol; Stephan A. Mayer; E. Sander Connolly
• Keywords: Antifibrinolytic; Aminocaproic acid

epsilon-Aminocaproic acid (EACA) is an antifibrinolytic agent used to prevent rebleeding in aneurysmal subarachnoid hemorrhage. Although studies have found that a decrease with long-term therapy offset by increase ischemic deficits, more recent indicated early, short-term may be beneficial.We instituted protocol for acute EACA administration starting at diagnosis and continued maximum duration of 72 hours after hemorrhage onset. We compared 73 patients treated 175 non-EACA-treated patients. sought identify differences the occurrence rebleeding, side effects, outcome.Baseline characteristics were similar 2 groups. There was significant EACA-treated (2.7%) versus non-EACA (11.4%). no difference complications between cohorts. 8-fold deep venous thrombosis group but pulmonary embolism. nonsignificant 76% reduction mortality attributable 13.3% favorable outcome good-grade patients, 6.8% poor-grade patients.When acutely, treatment resulted decreased without serious effects our selected Randomized placebo-controlled trials are needed determine whether should accepted as standard care all