title: Catheter based selective hypothermia reduces stroke volume during focal cerebral ischemia in swine.
abstract: BACKGROUND
  Total body hypothermia is an established neuroprotectant in global cerebral ischemia. The role of hypothermia in acute ischemic stroke remains uncertain. Selective application of hypothermia to a region of focal ischemia may provide similar protection with more rapid cooling and elimination of systemic side effects. We studied the effect of selective endovascular cooling in a focal stroke model in adult domestic swine.
  
  
  METHODS
  After craniotomy under general anesthesia, a proximal middle cerebral artery branch was occluded for 3 h, followed by 3 h of reperfusion. In half of the animals, selective hypothermia was induced during reperfusion using a dual lumen balloon occlusion catheter placed in the ipsilateral common carotid artery. Following reperfusion, the animals were sacrificed. Brain MRI and histology were evaluated by experts who were blinded to the intervention.
  
  
  RESULTS
  25 animals were available for analysis. Using selective hypothermia, hemicranial temperature was successfully cooled to a mean of 26.5 °C. Average time from start of perfusion to attainment of moderate hypothermia (<30 °C) was 25 min. Mean MRI stroke volumes were significantly reduced by selective cooling (0.050±0.059 control, 0.005±0.011 hypothermia (ratio stroke:hemisphere volume) (p=0.046). Stroke pathology volumes were reduced by 42% compared with controls (p=0.256).
  
  
  CONCLUSIONS
  Selective moderate hypothermia was rapidly induced using endovascular techniques in a clinically realistic swine stroke model. A significant reduction in stroke volume on MRI was observed. Endovascular selective hypothermia can provide neuroprotection within time frames relevant to acute ischemic stroke treatment.
authors: Department of Clinical Neurological Sciences, Western University, London, Ontario, Canada.
authors: Thomas K
authors: TK
authors: Mattingly
authors: Department of Clinical Neurological Sciences, Western University, London, Ontario, Canada.
authors: Lynn M
authors: LM
authors: Denning
authors: Department of Clinical Neurological Sciences, Western University, London, Ontario, Canada.
authors: Karen L
authors: KL
authors: Siroen
authors: Department of Medical Imaging, Western University, London, Ontario, Canada.
authors: Barb
authors: B
authors: Lehrbass
authors: Department of Clinical Neurological Sciences, Western University, London, Ontario, Canada Department of Medical Imaging, Western University, London, Ontario, Canada.
authors: Pablo
authors: P
authors: Lopez-Ojeda
authors: Department of Statistics, Stitt Statistical Services, Inc, London, Ontario, Canada.
authors: Larry
authors: L
authors: Stitt
authors: Department of Clinical Neurological Sciences, Western University, London, Ontario, Canada Department of Medical Imaging, Western University, London, Ontario, Canada.
authors: David M
authors: DM
authors: Pelz
authors: Department of Pathology, Western University, London, Ontario, Canada.
authors: Sumit
authors: S
authors: Das
authors: Department of Pathology, Western University, London, Ontario, Canada.
authors: Lee-Cyn
authors: LC
authors: Ang
authors: Department of Clinical Neurological Sciences, Western University, London, Ontario, Canada Department of Medical Imaging, Western University, London, Ontario, Canada.
authors: Donald H
authors: DH
authors: Lee
authors: Department of Clinical Neurological Sciences, Western University, London, Ontario, Canada Department of Medical Imaging, Western University, London, Ontario, Canada.
authors: Stephen P
authors: SP
authors: Lownie
mesh_terms: D000818:Animals; D021721:Balloon Occlusion / Q000379:methods*; D002545:Brain Ischemia / Q000175:diagnosis / Q000628:therapy*; D002404:Catheterization / Q000379:methods; D004195:Disease Models, Animal; D007036:Hypothermia, Induced / Q000379:methods*; D020521:Stroke / Q000175:diagnosis / Q000628:therapy*; D013552:Swine
keywords: Catheter; Intervention; Stroke