Intra-Aortic Balloon Counterpulsation Augments Cerebral Blood Flow in a Canine Model of Subarachnoid Hemorrhage-Induced Cerebral Vasospasm

Nussbaum, Eric S.; Heros, Roberto C.; Solien, Eric; Madison, Michael T.; Sebring, Leslie A.; Latchaw, Richard E.

doi:10.1097/00006123-199504000-00047

Cited by 7 publications

(7 citation statements)

References 30 publications

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“…Furthermore, other reports suggest that it is the augmentation of cardiac output, rather than raised arterial blood pressure, that increases CBF in conditions characterized by low cardiac output 20 or cerebral vasospasm. 21,22 On the basis of responses to hypercapnia, data from Georgiadis et al 23 recently suggested that the cerebral arteriolar dilatory capacity becomes nearly exhausted in patients with severe CHF. The low CBF in this study is compatible with this suggestion.…”

Section: Discussionmentioning

confidence: 99%

Cerebral Blood Flow in Patients With Chronic Heart Failure Before and After Heart Transplantation

Gruhn¹,

Larsen²,

Boesgaard³

et al. 2001

Stroke

257

215

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Section: Discussionmentioning

confidence: 99%

Cerebral Blood Flow in Patients With Chronic Heart Failure Before and After Heart Transplantation

Gruhn¹,

Larsen²,

Boesgaard³

et al. 2001

Stroke

257

215

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“…Experimental animal studies have shown that intra-aortic counterpulsation augments cerebral blood flow (CBF) in cerebral ischemia and subarachnoid hemorrhage vasospasm models [1,2]. In these cases, cerebral autoregulation (CA) is regionally impaired and cerebrovascular reactivity (CVR) in ischemic territories is restricted [3,4].…”

Section: Introductionmentioning

confidence: 99%

Does External Counterpulsation Augment Mean Cerebral Blood Flow in the Healthy Brain? Effects of External Counterpulsation on Middle Cerebral Artery Flow Velocity and Cerebrovascular Regulatory Response in Healthy Subjects

Junge-Huelsing

Liman²,

Brunecker³

et al. 2010

Cerebrovasc Dis

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Background and Purpose:External counterpulsation (ECP) noninvasively improves myocardial and organ perfusion via diastolic augmentation. The effects on cerebral blood flow velocities (CBFV) and hemodynamics are controversial. In this study, the effect of active ECP treatment on CBF in healthy subjects was continuously measured. Methods: In 9 healthy volunteers (mean age 34.1 ± 11.1 years, 4 females), 20-min active ECP treatment was performed. CBFV in the middle cerebral artery were detected via transcranial Doppler. CBFV were registered continuously before, during and after ECP. The protocol was repeated twice. Results: At onset of ECP, immediate changes in CBFV were observed: peak diastolic blood flow velocities increased from baseline to treatment (63 vs. 76 cm/s; p < 0.001) and diastolic blood flow augmentation was maintained throughout ECP. Peak systolic (87 vs. 78 cm/s; p < 0.001) and end-diastolic velocities (40 vs. 28 cm/s; p < 0.001) decreased significantly, while mean CBFV maintained constant (59 vs. 58 cm/s; not significant). The pulsatility index and resistance index as indirect parameters for peripheral vascular resistance increased during ECP (pulsatility index 0.79 vs. 0.89, p < 0.001; resistance index 0.54 vs. 0.64; p < 0.001). Conclusions: ECP did not increase mean CBFV in healthy subjects even though peak diastolic CBFV were significantly augmented. Changes in CBFV and transcranial Doppler waveform characteristics suggest that the mean flow of the middle cerebral artery is maintained stable via cerebrovascular autoregulatory mechanisms.

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“…In 1989, Tranmer et al [12] reported a 15% mean increase in cerebral blood flow after initiation of IABP in an animal model of cerebral ischemia induced by internal carotid occlusion. More recently, Nussbaum et al [13] reported a 20% mean increase (7%-50%) in cerebral blood flow in 10 of 10 dogs after treatment with IABP in a hemorrhage model of cerebral vasospasm. Nussbaum et al [14] reported another case report of a patient with severe cerebral vasospasm and cardiac dysfunction treated with IABP through utilization of Xenon-enhanced computed tomography to obtain serial measurements of cerebral blood flow with and without IABP over a period of 4 days, which demonstrated significant improvement in cerebral blood flow with IABP.…”

Section: Discussionmentioning

confidence: 99%

Intra‐aortic counterpulsation during carotid stenting

Hennen

Gröschel-Guth

Scheller

et al. 2001

Cathet Cardio Intervent

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Postprocedural hypotension following endovascular stent placement of carotid artery disease (CAS) predicts increased in-hospital complications and long-term risk of death. Intra-aortic balloon counterpulsation (IABP) both increases mean arterial pressure and cerebral blood flow and therefore possibly reduces complications due to hemodynamic instability during and after CAS. In this study, we describe the use of IABP in a patient with severe depression of left ventricular function due to diffuse coronary artery disease undergoing CAS. Controlled studies are necessary to demonstrate a potentially protective role of IABP in high-risk CAS patients.

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Intra-Aortic Balloon Counterpulsation Augments Cerebral Blood Flow in a Canine Model of Subarachnoid Hemorrhage-Induced Cerebral Vasospasm

Cited by 7 publications

References 30 publications

Cerebral Blood Flow in Patients With Chronic Heart Failure Before and After Heart Transplantation

Cerebral Blood Flow in Patients With Chronic Heart Failure Before and After Heart Transplantation

Does External Counterpulsation Augment Mean Cerebral Blood Flow in the Healthy Brain? Effects of External Counterpulsation on Middle Cerebral Artery Flow Velocity and Cerebrovascular Regulatory Response in Healthy Subjects

Intra‐aortic counterpulsation during carotid stenting

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