ArticleNeurocritical care2025
Prospective Trial of Cerebrospinal Fluid Filtration After Aneurysmal Subarachnoid Hemorrhage via Lumbar Catheter Extension (PILLAR-XT).
Article in Neurocritical care, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 1 paper.
What it found
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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.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
1 citing paper in PubMed.
- CSF diversion after aneurysmal sub-arachnoid hemorrhage: towards personalized treatment strategies.Critical care (London, England) · 2025Review
Corrections and comments
- Erratum issued
Authors and funding
9 authors.
Funding
Abstract
backgroundThere is a growing consensus that blood in the cerebrospinal fluid (CSF) is deleterious to outcomes in patients with aneurysmal subarachnoid hemorrhage. The extracorporeal filtration of subarachnoid hemorrhage via spinal catheter extension study evaluated the safety, tolerability, and filtration curve of blood and its lysis products from hemorrhagic CSF using the Neurapheresis CSF Management System.
methodsAfter aneurysm repair, a dual-lumen intrathecal catheter was inserted into the study participant's spinal canal. CSF was extracorporeally filtered for up to 72 h, removing blood products from the lumbar cistern, and reintroducing filtered CSF to the thoracic subarachnoid space. Neurological examinations were performed every 2 h, computed tomography scans were captured five times, and CSF samples were evaluated for cell counts every 8 h. Clinical follow-up evaluations were conducted 2 and 30 days after treatment.
resultsTwenty-seven of 29 study participants (93%) had a catheter successfully inserted. The median rate of waste removal was 5.7 mL/hr (interquartile range 3.9-8.8), and the median CSF filtration duration was 37:00 h (interquartile range 24:03-38:52). CSF red blood cell (mean reduction of 86%) and protein cell counts (mean reduction of 82%) decreased much faster in Neurapheresis system-treated participants compared with published data from standard-of-care patients with aneurysmal subarachnoid hemorrhage. From study participant screening through catheter removal, intracranial blood (evaluated via Hijdra Sum Score) decreased by 65%. In four study participants, there were a total of five adverse events, among whom one was determined per protocol to be a serious adverse event. All five events were mild or moderate severity and resolved with no clinical sequelae.
conclusionsThe Extracorporeal Filtration of Subarachnoid Hemorrhage Via Spinal Catheter Extension study demonstrated the potential to significantly accelerate intracranial blood elimination based on imaging (Hijdra Sum Score) and CSF red blood cell and protein reduction measures via a closed-loop filtration system.
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