Rapid induction of brain hypothermia by endovascular intra-arterial perfusion

Furuse, Motomasa; Preul, Mark C.; Kinoshita, Yoshihiko; Nishihara, Kentaro; Isono, Naofumi; Kuroiwa, Toshihiko

doi:10.1179/174313206x152537

Cited by 12 publications

(12 citation statements)

References 17 publications

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“…Although edaravone did not demonstrate an enhanced neuroprotective effect at mild hypothermia, this novel free-radical scavenger showed significant neuroprotection at both normothermia and mild hyperthermia. The induction of hypothermia requires special equipment 42 and a time frame to attain a particular hypothermic temperature. In contrast, edaravone can be administered quite easily and has a relatively wider therapeutic time window.…”

Section: Discussionmentioning

confidence: 99%

Small temperature variations alter edaravone-induced neuroprotection of cortical cultures exposed to prolonged hypoxic episodes

Shibuta

Varathan

Kamibayashi

et al. 2010

British Journal of Anaesthesia

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Section: Discussionmentioning

confidence: 99%

Small temperature variations alter edaravone-induced neuroprotection of cortical cultures exposed to prolonged hypoxic episodes

Shibuta

Varathan

Kamibayashi

et al. 2010

British Journal of Anaesthesia

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“…In 2007, Furuse and colleagues first evaluated IA-CSI in large animals. Infusion into the common carotid artery of six adult canines using a 4-French angiographic catheter rapidly achieved target hypothermic temperatures in target brain parenchyma [51]. Ipsilateral brain tissue was reduced to 33.6 °C by continuous infusion of ringer's solution (6.5 °C) at a rate of 3 ml/kg/min for 30 minutes.…”

Section: Ia-csi In Large Animal Studies Of Strokementioning

confidence: 99%

Intra-arterial Cold Saline Infusion in Stroke: Historical Evolution and Future Prospects

Wu¹,

Huber²,

Wu³

et al. 2020

Aging and disease

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Acute ischemic stroke (AIS) is a perpetual threat to life and functionality due to its high morbidity and mortality. In the past several decades, therapeutic hypothermia has garnered interest as an effective neuroprotective method in the setting of AIS. However, traditional hypothermic methods have been criticized for their low cooling efficiency and side effects. Intra-arterial cold saline infusion (IA-CSI), as a novel hypothermic method, not only minimizes these side effects, but is also perfectly integrated with widely accepted recanalization modalities in AIS, thereby serving as a promising prospect for clinical translation. In this article, we review the historical development of IA-CSI, summarize major studies of IA-CSI in rodents, large animals, and humans to date, and suggest insight into future development prospects in the field of AIS. We hope that this article will provide inspiration for the future application of hypothermia in AIS patients.

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“…These techniques use strategies such as extracorporeal infusion of cold blood or saline directly into the brain via the carotid arteries (Schwartz et al, 1996;Luan et al, 2004;Furuse et al, 2007), retrograde perfusion of the jugular vein (Wen et al, 2005), epidural cooling (Cheng et al, 2006), or topical scalp/skull cooling with a cooling helmet or a cooling coil (Wang et al, 2004;Clark and Colbourne, 2007). Although these techniques produced fewer systemic adverse effects than whole body hypothermia, they are still limited for clinical application due to the invasive nature of the extracorporeal circulation and the temperature gradient effects of the topical skull cooling (Clark and Colbourne, 2007).…”

Section: Introductionmentioning

confidence: 99%

Extraluminal Cooling of Bilateral Common Carotid Arteries as a Method to Achieve Selective Brain Cooling for Neuroprotection

Hartings

Yang

et al. 2008

Journal of Neurotrauma

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Systemic cooling to achieve brain hypothermia has been investigated as a neuroprotective therapy but can present serious adverse effects. Here we describe a novel method to selectively cool the rat brain and investigate its neuroprotective effects following transient middle cerebral artery occlusion (MCAo). The novelty of our method of selective brain cooling (SBC) was that the extraluminal cooling of the carotid arterial blood was achieved by using a cooling cuff wrapped around each common carotid artery (CCA). Within 20 min of CCA cooling, brain temperature could be lowered by 2-5 degrees C below the baseline and maintained stable for approximately 2 h while maintaining body temperature at 37 degrees C. No adverse effects of SBC were observed on systemic physiology, regional cerebral blood flow (rCBF), bleeding time, or tissue histology in normal animals. In rats having sustained 2-h MCAo, intra-ischemic SBC for 90 min, initiated 30 min following the onset of ischemia, significantly reduced infarction measured at 24 h post-injury (normothermic rats=312+/-51 mm3, SBC rats=139+/-83 mm3). In subgroup experiments, the incidence of peri-infarct depolarization (PID) was assessed during the MCAo and cooling period. Compared to normothermic but ischemic rats, SBC significantly reduced the number of PID events from 6.2+/-2.5 to 2.0+/-2.5, and reduced infarct volumes from 323+/-79 to 139+/-102 mm3. In conclusion, this extralumimal cooling method of SBC provides a safe and efficient approach to rapidly and safely achieve hypothermic neuroprotection.

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Rapid induction of brain hypothermia by endovascular intra-arterial perfusion

Abstract: Brain hypothermia was rapidly and safely induced using an intra-arterial crystalloid infusion and an extracorporeal cooing-filtration system. With refinement and further assessment of metabolic and physiologic parameters, the method holds a potential for clinical utility.

Cited by 12 publications

References 17 publications

Small temperature variations alter edaravone-induced neuroprotection of cortical cultures exposed to prolonged hypoxic episodes

Small temperature variations alter edaravone-induced neuroprotection of cortical cultures exposed to prolonged hypoxic episodes

Intra-arterial Cold Saline Infusion in Stroke: Historical Evolution and Future Prospects

Extraluminal Cooling of Bilateral Common Carotid Arteries as a Method to Achieve Selective Brain Cooling for Neuroprotection

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