The beneficial effects of clazosentan on the perioperative management of patients with subarachnoid hemorrhage.

The prevalence of angiographic vasospasm was significantly lower in the clazosentan group than in the fasudil group.

• Angiographic vasospasm occurred in 32.1% of clazosentan-treated patients vs. 59.2% of fasudil-treated patients (p < 0.01).
• Study population comprised 102 consecutive patients with aSAH: 49 received conventional treatment (fasudil with triple-H therapy) and 53 were treated with clazosentan.
• The two groups were separated by treatment era: fasudil group before May 2022, clazosentan group thereafter.

The incidence of vasospasm-related delayed cerebral ischemia (DCI) and favorable outcomes at discharge tended to be better in the clazosentan group, but these differences were not statistically significant.

• Vasospasm-related DCI and favorable discharge outcomes showed a trend favoring clazosentan without reaching statistical significance.
• No specific p-values or numerical rates for DCI or favorable outcomes were reported in the abstract.

Sitting training was initiated significantly earlier in the clazosentan group than in the fasudil group.

• Sitting training was initiated at a mean of 6.5 days in the clazosentan group vs. 10.7 days in the fasudil group (p < 0.01).
• Despite equivalent timing of rehabilitation initiation overall, sitting training showed a meaningful earlier start in the clazosentan group.

Physiotherapy in the training room was initiated significantly earlier in the clazosentan group than in the fasudil group.

• Physiotherapy in the training room began at a mean of 11.8 days in the clazosentan group vs. 16.1 days in the fasudil group (p < 0.01).
• This finding suggests clazosentan management facilitated more rapid progression through rehabilitation milestones.

Length of hospital stay was significantly shorter in the clazosentan group than in the fasudil group.

• Mean length of hospital stay was 22.3 days in the clazosentan group vs. 29.6 days in the fasudil group (p < 0.01).
• This represents a reduction of approximately 7.3 days in hospitalization duration associated with clazosentan-based management.

Clazosentan has been approved in Japan for the prevention of cerebral vasospasm in patients with aneurysmal subarachnoid hemorrhage.

• Prior to clazosentan, conventional treatment consisted of fasudil combined with triple-H therapy.
• The study design was a consecutive cohort comparison reflecting a change in institutional protocol rather than a randomized trial.