Evidence map›Paper›PMID 41927990›Full record

ArticleNeurocritical care2026

Combination of Albumin and Cilostazol Improves Outcomes in a Rodent Model of Aneurysmal Subarachnoid Hemorrhage.

A Karim Ahmed, James Feghali, Yu-Chien Shih, Jackson Miller, Eli Yazigi, Landon J Hansen, Jawad Khalifeh, Sai Chandan Reddy, Risheng Xu, Justin Caplan and 5 more

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Article in Neurocritical care, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

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0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

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PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors.

A Karim AhmedDepartment of Neurosurgery, Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Phipps 102, Baltimore, MD, 21287, USA.
James FeghaliDepartment of Neurosurgery, Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Phipps 102, Baltimore, MD, 21287, USA.
Yu-Chien ShihDepartment of Neurosurgery, Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Phipps 102, Baltimore, MD, 21287, USA.
Jackson MillerDepartment of Neurosurgery, Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Phipps 102, Baltimore, MD, 21287, USA.
Eli YazigiDepartment of Neurosurgery, Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Phipps 102, Baltimore, MD, 21287, USA.
Landon J HansenDepartment of Neurosurgery, Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Phipps 102, Baltimore, MD, 21287, USA.
Jawad KhalifehDepartment of Neurosurgery, Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Phipps 102, Baltimore, MD, 21287, USA.
Sai Chandan ReddyDepartment of Neurosurgery, Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Phipps 102, Baltimore, MD, 21287, USA.
Risheng XuDepartment of Neurosurgery, Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Phipps 102, Baltimore, MD, 21287, USA.
Justin CaplanDepartment of Neurosurgery, Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Phipps 102, Baltimore, MD, 21287, USA.
L Fernando GonzalezDepartment of Neurosurgery, Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Phipps 102, Baltimore, MD, 21287, USA.
Rafael J TamargoDepartment of Neurosurgery, Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Phipps 102, Baltimore, MD, 21287, USA.
Judy HuangDepartment of Neurosurgery, Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Phipps 102, Baltimore, MD, 21287, USA.
Jose I SuarezDepartment of Neurosurgery, Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Phipps 102, Baltimore, MD, 21287, USA.
Christopher M JacksonDepartment of Neurosurgery, Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Phipps 102, Baltimore, MD, 21287, USA. cjacks53@jhmi.edu.ORCID http://orcid.org/0000-0002-5958-2004

Funding

Grifols data analysis of the study.Grifols executionGrifols Funding for this study was provided by a research grant from Grifols Pharmaceuticals (BarcelonaGrifols Spain). This was an investigator-initiated study (Drs JacksoGrifols Suarez co-PIs). The funder had no role in the design
6 · The paper itself

Abstract

BACKGROUND AND

objectivesPatients recovering from aneurysmal subarachnoid hemorrhage (aSAH) often suffer secondary neurologic injury owing to delayed cerebral ischemia (DCI)-a multifactorial phenomenon. Both albumin and cilostazol have shown efficacy for treating DCI in preclinical and early clinical studies. However, the utility of combining these treatments has not yet been rigorously tested.

methodsA total of 83 mice, male and female, were randomly divided into five groups as follows: sham; vehicle (0.9% saline); 25% human albumin; cilostazol; and combination 25% human albumin with cilostazol. A total of 11 animals in each group underwent endovascular perforation of the internal carotid artery (ICA) to induce subarachnoid hemorrhage. Daily neuroscores were assessed for each animal, and brain water content was quantified as a surrogate for edema 96 h posthemorrhage. An additional five animals in each group underwent 11.7 T magnetic resonance imaging (MRI) and magnetic resonance angiography (MRA) at 96 h to quantify vasospasm.

resultsThere was a significant difference in vessel diameter in the left subclavian artery (L SCA; p = 0.014), right subclavian artery (R SCA; p = 0.018), and right internal carotid artery (R ICA; p = 0.026) in the experimental groups with combined treatment outperforming vehicle or either cilostazol or albumin monotherapy. Compared with SAH with vehicle control, treatment with albumin and cilostazol resulted in significantly improved MCA territory pixel intensity (p = 0.017). The treatment groups all had lower brain water contents than the SAH group, most pronounced in the SAH + albumin with cilostazol group compared with the SAH group (p < 0.001). There was a significant overall difference in survival between the groups (p < 0.001), and median neuroscore at all time points in the SAH + combined treatment group, compared with SAH alone; at 24 h (p = 0.036), 48 h (p = 0.001), 72 h (p = 0.001), and 96 h (p = 0.001).

conclusionsCombination albumin and cilostazol resulted in superior outcomes, including brain water content (edema), large vessel vasospasm, behavioral scores, and survival across brain water content, MRA imaging, 28-point neuroscore, and Kaplan-Meier analysis. These preclinical data support the need for a clinical trial testing this combination therapy.

Indexed as

AlbuminaSAHCilostazolDCIICA perforation

Identifiers

PMID41927990

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.