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Published Online
on June 26, 2003

Stroke. 2003
Published online before print June 26, 2003, doi: 10.1161/01.STR.0000079813.31539.6D
A more recent version of this article appeared on August 1, 2003
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Submitted on February 12, 2003
Accepted on March 10, 2003

Ultrarapid, Convection-Enhanced Intravascular Hypothermia. Feasibility Study in Nonhuman Primate Stroke

William J. Mack MD; Judy Huang MD; Christopher Winfree MD; Grace Kim BS; Marcelo Oppermann MD; John Dobak MD; Becky Inderbitzen MSE; Steve Yon PhD; Sulli Popilskis DVM; Juan Lasheras PhD; Robert R. Sciacca EngScD; David J. Pinsky MD; and E. Sander Connolly MD*

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.


Key words: hypothermia • primates • stroke • baboons




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