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Submitted on February 12, 2003
From the Departments of Neurosurgery (W.J.M., J.H., C.W., G.K., M.O., S.P., E.S.C.), Medicine (D.J.P.), and Biostatistics (R.R.S.), Columbia University, New York, NY; Innercool Therapies, Inc, San Diego, Calif (J.D., B.I., S.Y.); and Department of Mechanical and Aerospace Engineering, University of California, San Diego (J.L.). * To whom correspondence should be addressed. E-mail: wjm32{at}columbia.edu.
Background and Purpose--Hypothermia has been shown to be neuroprotective in a variety of clinical settings. Unfortunately, poor delivery techniques and insufficient data in appropriate preclinical models have hampered its development in human stroke. To address these limitations, we have devised a 10F intravascular catheter capable of rapid systemic cooling of nonhuman primates. Methods--Placed in the inferior vena cava via a transfemoral approach, the catheter was used to induce mild systemic hypothermia 3 hours after the onset of hemispheric stroke in baboons. Results--Cooling was achieved at a rate of 6.3±0.8°C/h. Target brain temperatures (32.2±0.2°C) were reached at the same time (47.7±6.32 minutes) as target esophageal temperatures (32.0±0.0°C). Hypothermia was maintained for 6 hours in all animals. Animals did not experience the infections, coagulopathy, or cerebral edema commonly seen with surface cooling methods in human stroke. Conclusions--These data suggest that a brief episode of mild core hypothermia instituted at a clinically relevant time point can be achieved in primate stroke and that our intravascular cooling technique provides safe, rapid, and reproducible hypothermia.
Accepted on March 10, 2003
Ultrarapid, Convection-Enhanced Intravascular Hypothermia. Feasibility Study in Nonhuman Primate Stroke
William J. Mack MD;
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