Endovascular Cooling Catheter for Selective Brain Hypothermia: An Animal Feasibility Study of Cooling Performance

Cattaneo, Giorgio; Schumacher, M.; Maurer, Christoph J.; Wolfertz, J.; Jost, Tobias; Büchert, Michael; Keuler, A.; Boos, L.; Shah, Mukesch; Foerster, Katharina; Niesen, Wolf‐Dirk; Ihorst, Gabriele; Urbach, Horst; Meckel, Stephan

doi:10.3174/ajnr.a4625

Cited by 31 publications

(32 citation statements)

References 36 publications

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“…Unfortunately, a direct comparison of the resulting temperatures with human clinical studies is not possible as the catheter is still under development and the temperature measurements of cerebral tissue require invasive procedures. However, our results show a comparable course to measured data in sheep [20]. As in our studies, the cerebral temperature of the animals dropped strongly in the first few minutes, followed by a smaller approximately linear decrease.…”

Section: Discussionsupporting

confidence: 91%

Generation of a Simplified Brain Geometry for the Calculation of Local Cerebral Temperature using a 1D Hemodynamic Model

Daschner

Krames

Lutz

et al. 2019

Current Directions in Biomedical Engineering

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In Western countries, stroke is the third-most cause of death; 35- 55% of the survivors experience permanent disability. Mild therapeutic hypothermia (TH) showed neuroprotective effect in patients returning from cardiac arrest and is therefore assumed to decrease stroke induced cerebral damage. Recently, an intracarotid cooling sheath was developed to induce local TH in the penumbra using the cooling effect of cerebral blood flow via collaterals. Computational modeling provides unique opportunities to predict the resulting cerebral temperature without invasive procedures. In this work, we generated a simplified brain model to establish a cerebral temperature calculation using Pennes’ bio-heat equation and a 1D hemodynamics model of the cranial artery tree. In this context, we performed an extensive literature research to assign the terminal segments of the latter to the corresponding perfused tissue. Using the intracarotid cooling method, we simulated the treatment with TH for different degrees of stenosis in the middle cerebral artery (MCA) and analyzed the resulting temperature spatialtemporal distributions of the brain and the systemic body considering the influence of the collaterals on the effect of cooling.

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Section: Discussionsupporting

confidence: 91%

Generation of a Simplified Brain Geometry for the Calculation of Local Cerebral Temperature using a 1D Hemodynamic Model

Daschner

Krames

Lutz

et al. 2019

Current Directions in Biomedical Engineering

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“…In an interesting in vitro study, Cattaneo and colleagues have tested a balloon cooling catheter placed in the CCA during EST in an artificial vasculature model, and showed very effective cooling in the distal "vessel territory" during normal and reduced flow. 76 This device and other cooling methods will be increasingly studied for intra-or post-EST cooling in the near future. In fact, the small pilot trial, Reperfusion with Cooling in Cerebral Acute Ischemia I (ReCCLAIM I) suggested a protective effect of intrainterventional cooling and will lead to a phase II trial.…”

Section: Temperaturementioning

confidence: 99%

Intensive Care Management of the Endovascular Stroke Patient

Bösel

2016

Semin Neurol

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Acute ischemic stroke caused by the occlusion of large brain vessels can be treated effectively by mechanical thrombectomy, as proved by recent strong and consistent evidence from high-quality randomized trials. This new era of endovascular stroke treatment, however, poses particular challenges that go far beyond the so far gold standard of intravenous thrombolysis alone. Because these stroke patients usually present with severe neurologic deficits, may be unstable from cardiac or pulmonary instability, have to endure an invasive intervention of sometimes long duration, may suffer complications and require close postinterventional follow-up, they often demand intensive care measures. These involve monitoring, blood pressure adjustment, sedation and analgesia, possibly intubation and ventilation, often postprocedural transfer to an intensive care unit, and treatment of potential complications. Many of these aspects, however, have not been sufficiently clarified so far. In this review, the author aims to critically appraise the intensive care management elements of peri-interventional stroke management based on the current evidence, pathophysiologic considerations, and personal experience.

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“…Therefore, rational design of nanoparticles that are responsive to cold temperature and capable of cold-triggered drug release is in demand to minimize the systemic toxicity of the chemical adjuvants and improve the efficacy of cryosurgery against diseased cells/tissues at cold temperature (similar to that next to the surface of the frozen tissue iceball monitored intraoperatively). Because cold temperature can be achieved by cooling with ice readily available in a hospital setting without the need of any specialized instrument for surface cooling or by using cooling catheters for deep-tissue cooling [35–37], development of cold-responsive nanoparticles for drug delivery should facilitate the clinical application of both cryosurgery and nanomedicine.…”

Section: Introductionmentioning

confidence: 99%

Enhanced cancer therapy with cold-controlled drug release and photothermal warming enabled by one nanoplatform

et al. 2018

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Stimuli-responsive nanoparticles hold great promise for drug delivery to improve the safety and efficacy of cancer therapy. One of the most investigated stimuli-responsive strategies is to induce drug release by heating with laser, ultrasound, or electromagnetic field. More recently, cryosurgery (also called cryotherapy and cryoablation), destruction of diseased tissues by first cooling/freezing and then warming back, has been used to treat various diseases including cancer in the clinic. Here we developed a cold-responsive nanoparticle for controlled drug release as a result of the irreversible disassembly of the nanoparticle when cooled to below ∼10 °C. Furthermore, this nanoparticle can be used to generate localized heating under near infrared (NIR) laser irradiation, which can facilitate the warming process after cooling/freezing during cryosurgery. Indeed, the combination of this cold-responsive nanoparticle with ice cooling and NIR laser irradiation can greatly augment cancer destruction both in vitro and in vivo with no evident systemic toxicity.

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Endovascular Cooling Catheter for Selective Brain Hypothermia: An Animal Feasibility Study of Cooling Performance

Cited by 31 publications

References 36 publications

Generation of a Simplified Brain Geometry for the Calculation of Local Cerebral Temperature using a 1D Hemodynamic Model

Generation of a Simplified Brain Geometry for the Calculation of Local Cerebral Temperature using a 1D Hemodynamic Model

Intensive Care Management of the Endovascular Stroke Patient

Enhanced cancer therapy with cold-controlled drug release and photothermal warming enabled by one nanoplatform

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