Department of Neurosurgery, University of Texas Health Sciences Center at Houston, Houston, Texas.
Department of Neurology, Duke University Medical Center, Durham, North Carolina.
Oper Neurosurg (Hagerstown). 2019 May 1;16(5):E148-E153. doi: 10.1093/ons/opy151.
The amount of subarachnoid blood and the presence of toxic blood breakdown products in the cerebrospinal fluid (CSF) have long been associated with poor outcomes in aneurysmal subarachnoid hemorrhage. The Neurapheresis™ system (Minnetronix Inc, St. Paul, Minnesota) has been developed to filter CSF and remove blood products, and is being investigated for safety and feasibility in the ExtracorPoreal FILtration of subarachnoid hemorrhage via SpinaL CAtheteR (PILLAR) study. We report the first case using this novel device.
A 65-yr-old female presented with a ruptured left posterior communicating artery aneurysm. Following placement of a ventriculostomy and coil embolization of her aneurysm, the patient underwent placement of a lumbar dual lumen catheter for CSF filtration as part of the PILLAR study. In this case, a total of 9 h of filtration during 31 h of catheter indwelling resulted in 309.47 mL of processed CSF without complication. Computed tomography images demonstrated an interval reduction of subarachnoid hemorrhage immediately after filtration. The patient was discharged home on postbleed day 11 and at 30 d showed good recovery.
Safety of the Neurapheresis procedure was confirmed in this first case, and we will continue to evaluate safety of the Neurapheresis system through the PILLAR trial.
蛛网膜下腔中的血液量以及脑脊液（CSF）中有毒血液分解产物的存在，长期以来一直与蛛网膜下腔出血的不良预后相关。Neurapheresis™ 系统（明尼苏达州圣保罗市的 Minnetronix Inc. 公司开发）旨在过滤 CSF 并清除血液产物，目前正在 ExtracorPoreal FILtration of subarachnoid hemorrhage via SpinaL CAtheteR（PILLAR）研究中对其安全性和可行性进行研究。我们报告了首例使用该新型设备的病例。
一位 65 岁女性，因左侧后交通动脉动脉瘤破裂而就诊。在放置脑室引流管并对其动脉瘤进行线圈栓塞后，患者接受了腰椎双腔导管放置以进行 CSF 过滤，这是 PILLAR 研究的一部分。在该病例中，总共进行了 9 小时的过滤，在 31 小时的导管留置过程中，处理后的 CSF 为 309.47 mL，无并发症发生。CT 图像显示过滤后蛛网膜下腔出血立即减少。患者于出血后第 11 天出院，在 30 天时恢复良好。
首例病例证实了 Neurapheresis 手术的安全性，我们将继续通过 PILLAR 试验评估 Neurapheresis 系统的安全性。
