Selective intra-carotid blood cooling in acute ischemic stroke: A safety and feasibility study in an ovine stroke model |
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Authors: | Giorgio FM Cattaneo,Andrea M Herrmann,Sebastian A Eiden,Manuela Wieser,Elias Kellner,Soroush Doostkam,Patrick Sü ß ,Selina Kiefer,Lisa Fauth,Christoph J Maurer,Julia Wolfertz,Bjö rn Nitzsche,Michael Bü chert,Tobias Jost,Gabriele Ihorst,Jö rg Haberstroh,Christoph Mü lling,Christoph Strecker,Wolf-Dirk Niesen,Mukesch J Shah,Horst Urbach,Johannes Boltze,Stephan Meckel |
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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. |
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Keywords: | Acute ischemic stroke catheter endovascular stroke therapy hypothermia selective brain cooling |
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