naa a22 4500 510799264 CHVBK 20180411083347.0 cr unu---uuuuu 180411e20130801xx s 000 0 eng 10.1007/s12028-012-9735-8 doi (NATIONALLICENCE)springer-10.1007/s12028-012-9735-8 An Examination of Aneurysm Rerupture Rates with Epsilon Aminocaproic Acid [Elektronische Daten] [Albert Schuette, Ferdinand Hui, Nancy Obuchowski, Raymond Walkup, Charles Cawley, Daniel Barrow, Owen Samuels] Background: Epsilon aminocaproic acid (EACA) has been used in the past to prevent cerebral aneurysm rerupture. Recent studies have indicated that short-term treatment with EACA can lower rebleeding rates without significantly increasing ischemic or thrombotic complications or permanent shunt rates. The goal of this study is to determine the efficacy of EACA in the prevention of aneurysm rerupture at a high volume subarachnoid hemorrhage center. Methods: We conducted a retrospective study of 355 consecutive subarachnoid hemorrhage patients over a 2-year period under our current protocol for EACA use. Patients were divided by presentation time to our institution and whether the patient received EACA. The primary endpoints of the study were rebleeding rates, ischemic complications, thrombotic complications, vasospasm, shunt rates, and outcomes. Results: Rerupture rates were reduced by half in the entire pool of patients on EACA after controlling for Hunt and Hess Scores and Fisher Scores. In patients who received early aneurysm treatment, this effect persisted but was non-statistically significant due to the small numbers of reruptures. In addition, there was no evidence to suggest that EACA increased ischemic or thrombotic complications, vasospasm, or VPS rates. In patients presenting earlier than 24h to our institution, there was a non-significant trend toward worse outcomes after EACA use. This trend was reversed in patients arriving after 24h. Conclusion: There is evidence to suggest that EACA is protective from aneurysm rerupture without significant ischemic or thrombotic complications when used for less than 72h. However, if the aneurysm is treated, this effect is modest indicating that early aneurysm treatment remains the gold standard for rerupture prevention. Springer Science+Business Media, LLC, 2012 Aminocaproic acid nationallicence Subarachnoid hemorrhage nationallicence Aneurysm rerupture nationallicence Vasospasm nationallicence Rerupture nationallicence Schuette Albert Department of Neurosurgery, Emory University, 1365 Clifton Rd NE Suite 6200, 30322, Atlanta, GA, USA aut Hui Ferdinand Cerebrovascular Center, Cleveland Clinic Foundation, Cleveland, OH, USA aut Obuchowski Nancy Cerebrovascular Center, Cleveland Clinic Foundation, Cleveland, OH, USA aut Walkup Raymond Department of Neurosurgery, Emory University, 1365 Clifton Rd NE Suite 6200, 30322, Atlanta, GA, USA aut Cawley Charles Department of Neurosurgery, Emory University, 1365 Clifton Rd NE Suite 6200, 30322, Atlanta, GA, USA aut Barrow Daniel Department of Neurosurgery, Emory University, 1365 Clifton Rd NE Suite 6200, 30322, Atlanta, GA, USA aut Samuels Owen Department of Neurosurgery, Emory University, 1365 Clifton Rd NE Suite 6200, 30322, Atlanta, GA, USA aut Neurocritical Care Springer US; http://www.springer-ny.com 19/1(2013-08-01), 48-55 1541-6933 19:1<48 2013 19 12028 https://doi.org/10.1007/s12028-012-9735-8 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s12028-012-9735-8 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Schuette Albert Department of Neurosurgery, Emory University, 1365 Clifton Rd NE Suite 6200, 30322, Atlanta, GA, USA aut NATIONALLICENCE 700 1- Hui Ferdinand Cerebrovascular Center, Cleveland Clinic Foundation, Cleveland, OH, USA aut NATIONALLICENCE 700 1- Obuchowski Nancy Cerebrovascular Center, Cleveland Clinic Foundation, Cleveland, OH, USA aut NATIONALLICENCE 700 1- Walkup Raymond Department of Neurosurgery, Emory University, 1365 Clifton Rd NE Suite 6200, 30322, Atlanta, GA, USA aut NATIONALLICENCE 700 1- Cawley Charles Department of Neurosurgery, Emory University, 1365 Clifton Rd NE Suite 6200, 30322, Atlanta, GA, USA aut NATIONALLICENCE 700 1- Barrow Daniel Department of Neurosurgery, Emory University, 1365 Clifton Rd NE Suite 6200, 30322, Atlanta, GA, USA aut NATIONALLICENCE 700 1- Samuels Owen Department of Neurosurgery, Emory University, 1365 Clifton Rd NE Suite 6200, 30322, Atlanta, GA, USA aut NATIONALLICENCE 773 0- Neurocritical Care Springer US; http://www.springer-ny.com 19/1(2013-08-01), 48-55 1541-6933 19:1<48 2013 19 12028 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer