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Selective intra-carotid blood cooling in acute ischemic stroke : a safety and feasibility study in an ovine stroke model
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(2021) Selective intra-carotid blood cooling in acute ischemic stroke : a safety and feasibility study in an ovine stroke model. Journal of Cerebral Blood Flow & Metabolism . doi:10.1177/0271678X211024952 (In Press)
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Official URL: http://dx.doi.org/10.1177/0271678X211024952
Abstract
Selective therapeutic hypothermia (TH) showed promising preclinical results as a neuroprotective strategy in acute ischemic stroke. We aimed to assess safety and feasibility of an intracarotid cooling catheter conceived for fast and selective brain cooling during endovascular thrombectomy in an ovine stroke model.
Transient middle cerebral artery occlusion (MCAO, 3 h) was performed in 20 sheep. In the hypothermia group (n = 10), selective TH was initiated 20 minutes before recanalization, and was maintained for another 3 h. In the normothermia control group (n = 10), a standard 8 French catheter was used instead. Primary endpoints were intranasal cooling performance (feasibility) plus vessel patency assessed by digital subtraction angiography and carotid artery wall integrity (histopathology, both safety). Secondary endpoints were neurological outcome and infarct volumes.
Computed tomography perfusion demonstrated MCA territory hypoperfusion during MCAO in both groups. Intranasal temperature decreased by 1.1 °C/3.1 °C after 10/60 minutes in the TH group and 0.3 °C/0.4 °C in the normothermia group (p < 0.001). Carotid artery and branching vessel patency as well as carotid wall integrity was indifferent between groups. Infarct volumes (p = 0.74) and neurological outcome (p = 0.82) were similar in both groups.
Selective TH was feasible and safe. However, a larger number of subjects might be required to demonstrate efficacy.
| Item Type: | Journal Article | |||||||||
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| Subjects: | R Medicine > RC Internal medicine R Medicine > RD Surgery R Medicine > RM Therapeutics. Pharmacology |
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| Divisions: | Faculty of Science > Life Sciences (2010- ) | |||||||||
| Library of Congress Subject Headings (LCSH): | Cerebrovascular disease , Cerebrovascular disease -- Treatment, Cerebral ischemia, Blood-vessels -- Endoscopic surgery, Cold -- Therapeutic use, Immunotherapy , Cerebrovascular disease -- Immunotherapy , Cerebrovascular disease -- Animal models | |||||||||
| Journal or Publication Title: | Journal of Cerebral Blood Flow & Metabolism | |||||||||
| Publisher: | SAGE Publications | |||||||||
| ISSN: | 0271-678X | |||||||||
| Official Date: | 23 June 2021 | |||||||||
| Dates: |
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| DOI: | 10.1177/0271678X211024952 | |||||||||
| Status: | Peer Reviewed | |||||||||
| Publication Status: | In Press | |||||||||
| Publisher Statement: | Cattaneo GF, Herrmann AM, Eiden SA, et al. Selective intra-carotid blood cooling in acute ischemic stroke: A safety and feasibility study in an ovine stroke model. Journal of Cerebral Blood Flow & Metabolism. Copyright © 2021 by International Society for Cerebral Blood Flow and Metabolism. Reprinted by permission of SAGE Publications. https://doi.org/10.1177/0271678X211024952 | |||||||||
| Access rights to Published version: | Restricted or Subscription Access | |||||||||
| RIOXX Funder/Project Grant: |
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