A drug delivery system using copoly (lactic/glycol
acid) was tested to determine its efficacy and safety in preventing
cerebral vasospasm following
subarachnoid hemorrhage in dogs. Rod shaped implants (1 mm diameter, 10 mm length, and approximately 10% of
nicardipine) was prepared by a heat compression method. Ten dogs were assigned to two groups: double
hemorrhage group and double
hemorrhage group treated with implants. Vertebral angiography and arterial blood injection into the cisterna magna were performed, followed by midline suboccipital
craniectomy and
laminectomy of the atlas and placement of
nicardipine implants in the cisterna magna. On day 2, arterial blood injection into the cisterna magna was repeated (double
hemorrhage model). On day 7, vertebral angiography was repeated. The animals were then sacrificed and the brain and
blood clot were taken out. All the animals involved in both groups had been clinically well. Though 5 animals of the control group showed severe vasospasm, no vasospasm was observed in 3 animals and only very mild vasospasm in 2 of the
nicardipine-treated group. There was a statistically significant difference in diameter between the two groups (0.5 mm vs 1.1 mm, p = 0.009). Histological examination showed no specific changes related to implants. Furthermore, left frontotemporal
craniotomy and placement of
nicardipine implants in the carotid-optico cistern were preformed in 3 dogs. Neither clinical symptoms related to implants nor specific histological changes were observed (e.g.
hypotension, seizure). These results suggested that
nicardipine-prolonged release preparation is safe as well as effective for
cerebral vasospasm.