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(Stroke. 2003;34:1994.)
© 2003 American Heart Association, Inc.

Original Contributions

Ultrarapid, Convection-Enhanced Intravascular Hypothermia

A 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 E. Sander Connolly, Jr, 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.).

Correspondence to E. Sander Connolly, Jr, MD, Department of Neurosurgery, Neurological Institute, Room 435, 710 W 168th St, New York, NY 10032. E-mail esc5{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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