Ultrarapid, convection-enhanced intravascular hypothermia: a feasibility study in nonhuman primate stroke.
OBJECTIVE
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.
Mack
William J
WJ
Department of Neurosurgery, Columbia University, New York, NY, USA.
Huang
Judy
J
Winfree
Christopher
C
Kim
Grace
G
Oppermann
Marcelo
M
Dobak
John
J
Inderbitzen
Becky
B
Yon
Steve
S
Popilskis
Sulli
S
Lasheras
Juan
J
Sciacca
Robert R
RR
Pinsky
David J
DJ
Connolly
E Sander
ES
D000818:Animals; D001522:Behavior, Animal; D001794:Blood Pressure; D001831:Body Temperature; D001921:Brain / Q000098:blood supply / Q000473:pathology / Q000503:physiopathology; D002404:Catheterization / Q000295:instrumentation* / Q000379:methods; D002536:Cerebral Arteries / Q000503:physiopathology; D002544:Cerebral Infarction / Q000473:pathology / Q000517:prevention & control; D018481:Convection; D005240:Feasibility Studies; D006339:Heart Rate; D007036:Hypothermia, Induced / Q000295:instrumentation* / Q000379:methods*; D008279:Magnetic Resonance Imaging; D008297:Male; D009460:Neurologic Examination; D010215:Papio; D020127:Recovery of Function; D015424:Reperfusion; D012121:Respiration, Artificial; D020521:Stroke / Q000503:physiopathology / Q000628:therapy*; D013997:Time Factors; D016896:Treatment Outcome; D014682:Vena Cava, Inferior / Q000502:physiology