Prospective Trial of Cerebrospinal Fluid Filtration after Aneurysmal Subarachnoid Hemorrhage via Lumbar Catheter (PILLAR)

Spiros L. Blackburn, Andrew W. Grande, Christa B. Swisher, Erik F. Hauck, Bharathi Jagadeesan, J. Javier Provencio

Research output: Contribution to journalArticlepeer-review

16 Scopus citations


Background and Purpose- The PILLAR (Extracorporeal Filtration of Subarachnoid Hemorrhage via Spinal Catheter) study is a first-in-human trial of cerebrospinal fluid (CSF) filtration in aneurysmal subarachnoid hemorrhage. The study evaluates the safety and feasibility of a novel filtration system to rapidly remove blood and blood breakdown products from CSF after securement of a ruptured aneurysm. Methods- Patients with aneurysmal subarachnoid hemorrhage had a dual-lumen lumbar, intrathecal catheter placed after aneurysm securement and received up to 24 hours of CSF filtration (neurapheresis therapy). The catheter aspirated blood-contaminated CSF from the lumbar cistern and returned filtered CSF to the thoracic subarachnoid space. Neuro checks were performed q2 hours, and CSF samples were collected for cell counts, total protein, and gram stain. Computed tomography scans were acquired at baseline and post-filtration. Clinical follow-up occurred at 2 weeks and 30 days. Results- Thirteen patients had a catheter placed (mean time 24:13 hours after ictus). The system processed 632.0 mL (180.6-1447.6 mL) CSF in 15:07 hours (5:32-24:00 hours) of filtration. The mean initial CSF red blood cell count, 2.78×10 5 cells/µL, reduced to 1.17×10 5 cells/µL after filtration (52.9% reduction), and total protein reduced 71%. Independent analysis of baseline and postfiltration computed tomographies found notable cisternal blood decrease, with 46.5% mean Hijdra Score reduction. Three mild, anticipated adverse events were reported. Conclusions- The initial safety and feasibility of Neurapheresis therapy in aneurysmal subarachnoid hemorrhage demonstrated the potential to safely filter CSF and remove blood and blood byproducts. Future studies are warranted. Clinical Trial Registration- URL: Unique identifier: NCT0287263.

Original languageEnglish (US)
Pages (from-to)2558-2561
Number of pages4
Issue number9
StatePublished - Sep 1 2019

Bibliographical note

Funding Information:
This study was supported by Minnetronix Neuro, Inc.

Publisher Copyright:
© 2019 American Heart Association, Inc.


  • Aneurysm, ruptured
  • Catheters
  • Cell counts
  • Subarachnoid hemorrhage
  • Tomography

PubMed: MeSH publication types

  • Research Support, Non-U.S. Gov't
  • Journal Article
  • Research Support, N.I.H., Extramural


Dive into the research topics of 'Prospective Trial of Cerebrospinal Fluid Filtration after Aneurysmal Subarachnoid Hemorrhage via Lumbar Catheter (PILLAR)'. Together they form a unique fingerprint.

Cite this