title: Hypothermia during Carotid Endarterectomy: A Safety Study.
abstract: BACKGROUND
  CEA is associated with peri-operative risk of brain ischemia, due both to emboli production caused by manipulation of the plaque and to potentially noxious reduction of cerebral blood flow by carotid clamping. Mild hypothermia (34-35°C) is probably the most effective approach to protect brain from ischemic insult. It is therefore a substantial hypothesis that hypothermia lowers the risk of ischemic brain damage potentially associated with CEA. Purpose of the study is to test whether systemic endovascular cooling to a target of 34.5-35°C, initiated before and maintained during CEA, is feasible and safe.
  
  
  METHODS
  The study was carried out in 7 consecutive patients referred to the Vascular Surgery Unit and judged eligible for CEA. Cooling was initiated 60-90 min before CEA, by endovascular approach (Zoll system). The target temperature was maintained during CEA, followed by passive, controlled rewarming (0.4°C/h). The whole procedure was carried out under anesthesia.
  
  
  RESULTS
  All the patients enrolled had no adverse events. Two patients exhibited a transient bradycardia (heart rate 30 beats/min). There were no significant differences in the clinical status, laboratory and physiological data measured before and after CEA.
  
  
  CONCLUSIONS
  Systemic cooling to 34.5-35.0°C, initiated before and maintained during carotid clamping, is feasible and safe.
  
  
  BACKGROUND
  ClinicalTrials.gov NCT02629653.
authors.affiliation: NESMOS (Neurosciences Mental Health and Sensory Organs) Department, School of Medicine and Psychology, Sapienza University, Sant'Andrea Hospital, Rome, Italy.
authors.forename: Serena
authors.initials: S
authors.lastname: Candela
authors.affiliation: Cardiothoracic Vascular Sciences Department, School of Medicine and Psychology, Sapienza University, Sant'Andrea Hospital, Rome, Italy.
authors.forename: Raffaele
authors.initials: R
authors.lastname: Dito
authors.affiliation: NESMOS (Neurosciences Mental Health and Sensory Organs) Department, School of Medicine and Psychology, Sapienza University, Sant'Andrea Hospital, Rome, Italy.
authors.forename: Barbara
authors.initials: B
authors.lastname: Casolla
authors.affiliation: Surgical Anesthetic Sciences Department; School of Medicine and Psychology, Sapienza University, Sant'Andrea Hospital, Rome, Italy.
authors.forename: Emanuele
authors.initials: E
authors.lastname: Silvestri
authors.affiliation: NESMOS (Neurosciences Mental Health and Sensory Organs) Department, School of Medicine and Psychology, Sapienza University, Sant'Andrea Hospital, Rome, Italy.
authors.forename: Giuliano
authors.initials: G
authors.lastname: Sette
authors.affiliation: Cardiothoracic Vascular Sciences Department, School of Medicine and Psychology, Sapienza University, Sant'Andrea Hospital, Rome, Italy.
authors.forename: Federico
authors.initials: F
authors.lastname: Filippi
authors.affiliation: Cardiothoracic Vascular Sciences Department, School of Medicine and Psychology, Sapienza University, Sant'Andrea Hospital, Rome, Italy.
authors.forename: Maurizio
authors.initials: M
authors.lastname: Taurino
authors.affiliation: Surgical Anesthetic Sciences Department; School of Medicine and Psychology, Sapienza University, Sant'Andrea Hospital, Rome, Italy.
authors.forename: Domitilla
authors.initials: D
authors.lastname: Brancadoro
authors.affiliation: NESMOS (Neurosciences Mental Health and Sensory Organs) Department, School of Medicine and Psychology, Sapienza University, Sant'Andrea Hospital, Rome, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Orzi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002545:Brain Ischemia / Q000209:etiology / Q000517:prevention & control*; D016894:Endarterectomy, Carotid / Q000009:adverse effects*; D005240:Feasibility Studies; D005260:Female; D006339:Heart Rate; D006801:Humans; D007035:Hypothermia; D008297:Male; D012449:Safety