Pellets successfully used to treat stroke complication

DALLAS (AP) _ Implanting tiny pellets of medicine into the brain may prevent a potentially dangerous complication that often affects victims of a certain type of stroke. <br><br>Patients who undergo surgery

Friday, April 5th 2002, 12:00 am

By: News On 6

DALLAS (AP) _ Implanting tiny pellets of medicine into the brain may prevent a potentially dangerous complication that often affects victims of a certain type of stroke.

Patients who undergo surgery to repair a ruptured blood vessel after a kind of stroke called a subarachnoid hemorrhage, or SAH, often develop a vasospasm, in which arteries in the head shrink, starving the brain of blood. A vasospasm is most likely to cause brain damage but can sometimes be deadly.

In a study of 20 SAH patients, Japanese researchers inserted two to 10 pellets the size of a grain of rice next to arteries they suspected would develop vasospasms. The pellets contained nicardipine, a type of medicine called a calcium channel blocker often used to treat high blood pressure.

In every case, arteries next to the pellets developed no vasospasms.

However, six patients developed a mild form of vasospasms in arteries farther away from where the pellets were inserted. One patient had mild contractions, another had vasospasms severe enough to cause disability.

Still, the frequency and severity of the vasospasms were far milder than without treatment, said lead author Dr. Hidetoshi Kasuya of the Tokyo Women's Medical University. No side effects were observed, he added.

The findings were reported in Thursday's issue of the American Heart Association journal Stroke.

Dr. Gregory Del Zoppo, associate professor at the Scripps Research Institute in La Joya, Calif., said oral calcium channel blockers are the conventional treatment for vasospasms, but they do not work well in all cases. Doctors are interested in alternatives, he said.

``I think at first blush it's a rather novel and clever way to increase the local concentration of calcium channel blockers,'' Del Zoppo said of the pellets.

SAH strokes affect some 28,000 North Americans annually, a surgery is required to patch the ruptured blood vessel. Between 50 percent and 70 percent of such patients develop vasospasms.

Kasuya said while scientists do not know what causes vasospasms, conventional treatment methods are not especially effective or are complicated and hazardous.

He said he now plans to conduct more research and work with a drug company interested in bringing the idea to market.

Dr. Mark Alberts, director of the stroke program at Northwestern Memorial Hospital in Chicago, said the treatment's main limitation is that it requires surgery to insert the pellets, and it appears to work well only on vessels near the implants. Alberts said delivering the medicine intravenously might prevent vasospasms throughout the brain.

``This certainly has the potential to be a significant advance,'' he said.