Combined Selective Cerebral Hypothermia and Mechanical Artery Recanalization in Acute Ischemic Stroke: In Vitro Study of Cooling Performance

Cattaneo, Giorgio; Schumacher, M.; Wolfertz, J.; Jost, Tobias; Meckel, Stephan

doi:10.3174/ajnr.a4434

Cited by 30 publications

(26 citation statements)

References 23 publications

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“…However, the recent introduction of new approaches to cerebral FH induction, including the use of a cooling neck collar and intracarotid infusion of cold saline, has shown great promise. 6,8,14 It should be noted that, in line with our results, hypothermia seems to be an effective strategy mainly in models of transient ischemia, suggesting that the combination of hypothermia and reperfusion therapies may be the most promising strategy in humans. 30 Although some data suggest that FH could be beneficial in permanent ischemia, 12 further studies are necessary to validate its use as a monotherapy.…”

Section: Strokesupporting

confidence: 81%

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Protective Effects and Magnetic Resonance Imaging Temperature Mapping of Systemic and Focal Hypothermia in Cerebral Ischemia

Vieites‐Prado

Iglesias‐Rey

Fernández-Susavila

et al. 2016

Stroke

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Background and Purpose-Hypothermia is potentially the most effective protective therapy for brain ischemia; however, its use is limited because of serious side effects. Although focal hypothermia (FH) has a significantly lower stress profile than systemic hypothermia (SH), its efficacy in ischemia has been poorly studied. We aimed to compare the therapeutic effects of each treatment on various short-and long-term clinically relevant end points. Methods-Sprague-Dawley rats were subjected to transient (45 minutes) occlusion of the middle cerebral artery. One hour after arterial reperfusion, animals were randomly assigned to groups for treatment with SH or FH (target temperature: 32°C) for 4 or 24 hours. Lesion volume, edema, functional recovery, and histological markers of cellular injury were evaluated for 1 month after ischemic injury. Effects of SH and FH on cerebral temperature were also analyzed for the first time by magnetic resonance thermometry, an approach that combines spectroscopy with gradient-echo-based phase mapping. Results-Both therapeutic approaches reduced ischemic lesion volume (P<0.001), although a longer FH treatment (24 hours) was required to achieve similar protective effects to those induced by 4 hours of SH. In addition, magnetic resonance thermometry demonstrated that systemic hypothermia reduced whole-brain temperature, whereas FH primarily reduced the temperature of the ischemic region. Conclusions-Focal brain hypothermia requires longer cooling periods to achieve the same protective efficacy as SH.However, FH mainly affects the ischemic region, and therefore represents a promising and nonstressful alternative to SH.

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Section: Strokesupporting

confidence: 81%

“…In fact, recent studies using novel devices to induce FH have shown promising results for stroke therapy. 7,8 However, no study to date has evaluated the comparative efficacies of SH and FH in patients with ischemic stroke.…”

mentioning

confidence: 99%

Protective Effects and Magnetic Resonance Imaging Temperature Mapping of Systemic and Focal Hypothermia in Cerebral Ischemia

Vieites‐Prado

Iglesias‐Rey

Fernández-Susavila

et al. 2016

Stroke

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“…15 In this study, the device and its functional properties were extensively outlined, including photographic and schematic images of the balloon cooling system. It consists of 4 serially arranged balloons at the catheter tip (diameter, 4 mm; length, 20 mm each) perfused with coolant (0.9% sodium chloride) that connect to a closed-loop inner-catheter cooling circuit without direct blood contact.…”

Section: Balloon Cooling Catheter Systemmentioning

confidence: 99%

“…14 Recently, we have developed an intracarotid cooling catheter system for combined MT and selective TH treatment. 15 It simultaneously serves as an access for the intracranial MT procedure and enables early cooling of the ischemic penumbra via collaterals before recanalization, to then provide a "cold reperfusion" of the ischemic core during and after MT treatment. The latter is expected to be a critical determinant of clinical outcome.…”

mentioning

confidence: 99%

Endovascular Cooling Catheter for Selective Brain Hypothermia: An Animal Feasibility Study of Cooling Performance

Cattaneo

Schumacher²,

Maurer³

et al. 2015

American Journal of Neuroradiology

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“…To analyze the mechanical behavior of blood vessels two approaches are usually used-in vitro exper-imental studies [7][8][9] and numerical simulations [10][11][12][13] . In the former studies, silicone in vitro devices were developed [7][8][9] to mimic the biomechanical behavior of real blood vessels [14] or cadaveric arteries were used to analyze some mechanical properties [15] . Nowadays numerical simulations are gaining relevance in this field due to the development of hardware and software that allows accurate simulations of the mechanical behavior of blood vessels, with or without pathologies [16][17][18][19][20] .…”

Section: Introductionmentioning

confidence: 99%

Biomechanical analysis of PDMS channels using different hyperelastic numerical constitutive models

Cardoso¹,

Fernandes²,

Lima³

et al. 2018

Mechanics Research Communications

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a b s t r a c tBrain aneurysms are pathological dilatations of cerebral arteries and are known as one of the most common and serious cerebrovascular events. However, patients with cerebral aneurysms do not exhibit evident symptoms until they rupture. The main objective of the present study is to perform numerical characterizations of the biomechanical behavior of aneurysms in order to analyze the blood vessel wall behavior during the formation of an aneurysm. By taking into account different geometric and physiological parameters, flow simulations of a well-known Newtonian fluid (glycerin) was performed using the commercial finite volume method package Ansys® -Fluent, and pressure along the channel was determined. These pressures were imported into the channel, in the Ansys®-Static Structural, in order to evaluate and analyze the displacement and strain fields in the channel wall, caused by the internal pressure induced by the fluid flow. All calculations were performed by using the most widely accepted hyperelastic constitutive models and it was found that any constitutive model can be applied to this kind of studies, allowing to visualize where pressure achieves its maximum value and consequently, the most favorable region where the rupture is more likely to occur.

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Combined Selective Cerebral Hypothermia and Mechanical Artery Recanalization in Acute Ischemic Stroke: In Vitro Study of Cooling Performance

Cited by 30 publications

References 23 publications

Protective Effects and Magnetic Resonance Imaging Temperature Mapping of Systemic and Focal Hypothermia in Cerebral Ischemia

Protective Effects and Magnetic Resonance Imaging Temperature Mapping of Systemic and Focal Hypothermia in Cerebral Ischemia

Endovascular Cooling Catheter for Selective Brain Hypothermia: An Animal Feasibility Study of Cooling Performance

Biomechanical analysis of PDMS channels using different hyperelastic numerical constitutive models

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