Abstract T P235: Assessing the Impact of Rotorcrafts in a Model of Induced Cerebral Embolism (AIR-MICE)
Objective: Stroke is a time-dependent emergency that often requires emergent helicopter evacuation, a critical early setting for which little is known about the positive or deleterious effect of altitude change, noise, acceleration and vibration. While many of these factors could worsen ischemic injury, the low frequency vibrations might augment clot lysis and enhance rtPA treatment. The objective of this study is to measure the feasibility, safety and potential effect of helicopter transport during thrombolysis in an animal model.
Methodology: Prospective, randomized, open intervention and blinded end-point pilot study that combines a controlled experimental model with a real life helicopter flight exposure. Subjects were adult C57BL/6 male mice that simultaneously underwent an embolic middle cerebral artery occlusion (eMCAO) in pairs. Each pair of mice were randomized to receive 10 mg/kg of rtPA at two hours after eMCAO either during a one hour local flight in a MI2 turbine helicopter, or to simultaneously receive the same rtPA infusion while waiting in an airport hangar. Mice were sacrificed at 24 h. Primary outcome measure was infarct volume. Secondary outcome was neurological scores.
Results: Eighteen mice (9 pairs) were analyzed. Lower infarction volumes were seen in the helicopter assigned group in 6/9 pairs. The mean infarction volumes were 246.6 mm3 (SD 154) for ground group and 213.6 mm3 (SD 170) for the helicopter group. A paired t-test analysis showed lesser infarction volumes in the helicopter group (mean difference 33 mm3, p=0.33), a difference that was not influenced when adjusting for ambient temperature and atmospheric pressure. The neurological scores were similar in the ground and helicopter groups (1.28 vs. 1.22, p=0.88).
Conclusion: Randomized trials of the effect of helicopter transport in a mouse model of eMCAO are feasible, and desirable to test the effect of neuroprotective therapies in this unique setting. These results endorse the safety of aerial transport, which might be associated with lower infarction volumes. The potential synergist effect of vibration in the rotorcraft with reperfusion needs to be explored further.
Author Disclosures: E.C. Leira: Research Grant; Significant; NINDS. M. Khan: None. A. Zaheer: Research Grant; Significant; VA, NIH. T. Schnell: None. J.C. Torner: None. H.M. Olalde: Research Grant; Significant; NINDS. N. Nagaraja: None. S. Ortega-Gutierrez: None. C. Pieper: None. H.P. Adams Jr.: None.
- © 2015 by American Heart Association, Inc.