Ultrarapid, convection-enhanced intravascular hypothermia: a feasibility study in nonhuman primate stroke

Stroke. 2003 Aug;34(8):1994-9. doi: 10.1161/01.STR.0000079813.31539.6D. Epub 2003 Jun 26.

Abstract

Background and purpose: Hypothermia has been shown to be neuroprotective in a variety of clinical settings. Unfortunately, poor delivery techniques and insufficient data in appropriate preclinical models have hampered its development in human stroke. To address these limitations, we have devised a 10F intravascular catheter capable of rapid systemic cooling of nonhuman primates.

Methods: Placed in the inferior vena cava via a transfemoral approach, the catheter was used to induce mild systemic hypothermia 3 hours after the onset of hemispheric stroke in baboons.

Results: Cooling was achieved at a rate of 6.3+/-0.8 degrees C/h. Target brain temperatures (32.2+/-0.2 degrees C) were reached at the same time (47.7+/-6.32 minutes) as target esophageal temperatures (32.0+/-0.0 degrees C). Hypothermia was maintained for 6 hours in all animals. Animals did not experience the infections, coagulopathy, or cerebral edema commonly seen with surface cooling methods in human stroke.

Conclusions: These data suggest that a brief episode of mild core hypothermia instituted at a clinically relevant time point can be achieved in primate stroke and that our intravascular cooling technique provides safe, rapid, and reproducible hypothermia.

Publication types

  • Evaluation Study
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Animals
  • Behavior, Animal
  • Blood Pressure
  • Body Temperature
  • Brain / blood supply
  • Brain / pathology
  • Brain / physiopathology
  • Catheterization / instrumentation*
  • Catheterization / methods
  • Cerebral Arteries / physiopathology
  • Cerebral Infarction / pathology
  • Cerebral Infarction / prevention & control
  • Convection*
  • Feasibility Studies
  • Heart Rate
  • Hypothermia, Induced / instrumentation*
  • Hypothermia, Induced / methods*
  • Magnetic Resonance Imaging
  • Male
  • Neurologic Examination
  • Papio
  • Recovery of Function
  • Reperfusion
  • Respiration, Artificial
  • Stroke / physiopathology
  • Stroke / therapy*
  • Time Factors
  • Treatment Outcome
  • Vena Cava, Inferior / physiology