Neuroprotection by selective endovascular brain cooling – the TwinFlo™ Catheter

Solar, Ronald J.; Mattingly, Thomas; Lownie, Stephen P.; Meerkin, David

doi:10.4244/eij-d-19-00316

Cited by 4 publications

(4 citation statements)

References 9 publications

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“…This cooled and medically processed blood is infused back into the cerebral circulation, often via the carotid artery. In another swine stroke model experiment, extracorporeal blood cooling led to a brain temperature decrease of >6 • C in ∼30 min (77). In contrast to SEBC with IACI (cold fluid or cold blood), local blood cooling via conduction, i.e., with a closed-loop intra-carotid catheter in which cold fluids circulate, is far less effective due to the limited dimensions of the parent artery and resulting limitations to the size and surface area of the heat-exchange catheter (78).…”

Section: The Promises Of Adjunct Endovascular Brain Hypothermiamentioning

confidence: 96%

Selective Brain Hypothermia in Acute Ischemic Stroke: Reperfusion Without Reperfusion Injury

et al. 2020

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Section: The Promises Of Adjunct Endovascular Brain Hypothermiamentioning

confidence: 96%

Selective Brain Hypothermia in Acute Ischemic Stroke: Reperfusion Without Reperfusion Injury

et al. 2020

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“…The duration of cerebral cold infusion–induced hypothermia in other small animal studies was shorter, and in some only 3 min [ 5 ]. Closed-loop cold autologous blood perfusion might overcome this limitation, but therapeutic heparinization required for preventing emboli formation at the catheter might be deleterious in the acute stroke setting especially when thrombolysis is conducted [ 33 ]. Intra-carotid balloon cooling catheter systems have been tested in sheep [ 29 , 34 ].…”

Section: Discussionmentioning

confidence: 99%

A System for Continuous Pre- to Post-reperfusion Intra-carotid Cold Infusion for Selective Brain Hypothermia in Rodent StrokeModels

Wang

Choi

Almekhlafi

et al. 2020

Transl. Stroke Res.

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Intra-carotid cold infusion (ICCI) appears as a promising method for hypothermia-mediated brain protection from ischemic stroke. Recent clinical pilot studies indicate easy implementation of ICCI into endovascular acute ischemic stroke treatment. Current rodent ICCI-in-stroke models limit ICCI to the post-reperfusion phase. To establish a method for continuous ICCI over the duration of intra-ischemia to post-reperfusion in rodent stroke models, a novel system was developed. Eighteen male Sprague-Dawley rats were included. Intraluminal filament method was used for transient middle cerebral artery occlusion (MCAO). Normal saline (~ 0 °C) was delivered (≤ 2.0 mL/min) into the internal carotid artery via a customized infusion system without interruption during MCAO (intra-ischemia) to after filament withdrawal (post-reperfusion). Bilateral cortical and striatal temperatures were monitored. Hypothermia goals were a temperature reduction in the ischemic hemisphere by 2 °C prior to reperfusion and thereafter maintenance of regional brain hypothermia at ~ 32 °C limiting the administered ICCI volume to ½ of each rat’s total blood volume. During ischemia, maximum brain cooling rate was achieved with ICCI at 0.5 mL/min. It took 2 min to reduce ischemic striatal temperature by 2.3 ± 0.3 °C. After reperfusion, brain cooling was continued at 2 mL/min ICCI first (over 42 s) and maintained at 32.1 ± 0.3 °C at 0.7 mL/min ICCI over a duration of 15 ± 0.8 min. ICCI (total 12.6 ± 0.6 mL) was uninterrupted over the duration of the studied phases. First system that allows continuous ICCI during the phases of intra-ischemia to post-reperfusion in small animals for selective brain cooling and for investigations of other neuroprotective infusions.

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“…reported the first human trial of TwinFlo catheter, in a 59-year-old patient with a large middle cerebral aneurysm that requires prolonged occlusion during surgical repair. [ 45 ] TwinFlo catheter was adopted to selectively cool the brain to a low temperature of 26° while maintaining a normal core temperature (36.7°). In terms of time, the total duration reaches 2 h, 65 min before arterial occlusion, 39 min after occlusion, and 16 min after ventilation.…”

Section: Endovascular Hypothermia Catheter Typesmentioning

confidence: 99%

A narrative review of intravascular catheters in therapeutic hypothermia

Gao,

Li,

Jiang

et al. 2024

Brain Circulation

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Therapeutic hypothermia (TH) has been regarded as a promising neuroprotective method for acute ischemic stroke (AIS) for decades. During the development of TH, most researchers focused on improving hypothermic benefits by optimizing treatment processes and conditions. Intravenous thrombolysis and endovascular thrombectomy, for instance, have been introduced into AIS treatment. However, the lack of specialized intervention consumables, especially intervention catheter, led to inaccurate and uncontrolled hypothermic temperature, limited the efficacy of TH. In this review, intervention catheters as well as accessory equipment utilized in TH treatment has been summarized. Hopefully, this review may inspire the future development of TH specialized intervention catheter, enhance the outcome of TH, and neuroprotective efficacy in AIS.

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Neuroprotection by selective endovascular brain cooling – the TwinFlo™ Catheter

Cited by 4 publications

References 9 publications

Selective Brain Hypothermia in Acute Ischemic Stroke: Reperfusion Without Reperfusion Injury

Selective Brain Hypothermia in Acute Ischemic Stroke: Reperfusion Without Reperfusion Injury

A System for Continuous Pre- to Post-reperfusion Intra-carotid Cold Infusion for Selective Brain Hypothermia in Rodent StrokeModels

A narrative review of intravascular catheters in therapeutic hypothermia

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