Combined local hypothermia and recanalization therapy for acute ischemic stroke: Estimation of brain and systemic temperature using an energetic numerical model

Publication date: Available online 4 July 2019Source: Journal of Thermal BiologyAuthor(s): Yannick Lutz, Axel Loewe, Stephan Meckel, Olaf Dössel, Giorgio CattaneoAbstractLocal brain hypothermia is an attractive method for providing cerebral neuroprotection for ischemic stroke patients and at the same time reducing systemic side effects of cooling. In acute ischemic stroke patients with large vessel occlusion, combination with endovascular mechanical recanalization treatment could potentially allow for an alleviation of inflammatory and apoptotic pathways in the critical phase of reperfusion. The direct cooling of arterial blood by means of an intra-carotid heat exchange catheter compatible with recanalization systems is a novel promising approach. Focusing on the concept of “cold reperfusion”, we developed an energetic model to calculate the rate of temperature decrease during intra-carotid cooling in case of physiological as well as decreased perfusion. Additionally, we discussed and considered the effect and biological significance of temperature decrease on resulting brain perfusion. Our model predicted a 2°C brain temperature decrease in 8.3,11.8and 26.2minat perfusion rates of 50,30 and 10ml100g⋅min, respectively. The systemic temperature decrease - caused by the venous blood return to the main circulation - was limited to .0.5°C in 60min. Our results underline the potential of catheter-assisted, intracarotid blood cooling to provide a fast and selective brain t...
Source: Journal of Thermal Biology - Category: Biology Source Type: research