| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
From The Cleveland Clinic Foundation (Drs. De Georgia, Krieger, and Abou-Chebl), OH, Erlanger Medical Center (Dr. Devlin), Chattanooga, TN, Justus Liebing University (Dr. Jauss), Giessen, Germany, Royal Melbourne Hospital (Dr. Davis), Australia, Massachusetts General Hospital (Drs. Koroshetz and Rordorf), Boston, and NIH (Dr. Warach), Bethesda, MD.
Address correspondence and reprint requests to Dr. M.A. De Georgia, Department of Neurology, Cleveland Clinic Foundation, 9500 Euclid Ave., Cleveland, OH 44195; e-mail: degeorm{at}ccf.org
Objective: To report results of a randomized pilot clinical feasibility trial of endovascular cooling in patients with ischemic stroke.
Methods: Forty patients with ischemic stroke presenting within 12 hours of symptom onset were enrolled in the study. An endovascular cooling device was inserted into the inferior vena cava of those randomized to hypothermia. A core body temperature of 33 °C was targeted for 24 hours. All patients underwent clinical assessment and MRI initially, at days 3 to 5 and days 30 to 37.
Results: Eighteen patients were randomized to hypothermia and 22 to receive standard medical management. Thirteen patients reached target temperature in a mean of 77 ± 44 minutes. Most tolerated hypothermia well. Clinical outcomes were similar in both groups. Mean diffusion-weighted imaging (DWI) lesion growth in the hypothermia group (n = 12) was 90.0 ± 83.5% compared with 108.4 ± 142.4% in the control group (n = 11) (NS). Mean DWI lesion growth in patients who cooled well (n = 8) was 72.9 ± 95.2% (NS).
Conclusions: Induced moderate hypothermia is feasible using an endovascular cooling device in most patients with acute ischemic stroke. Further studies are needed to determine if hypothermia improves outcome.
Received September 19, 2003. Accepted in final form March 10, 2004.
This article has been cited by other articles:
|
|
 |
|
  R. W. Neumar, J. P. Nolan, C. Adrie, M. Aibiki, R. A. Berg, B. W. Bottiger, C. Callaway, R. S.B. Clark, R. G. Geocadin, E. C. Jauch, et al. Post-Cardiac Arrest Syndrome: Epidemiology, Pathophysiology, Treatment, and Prognostication A Consensus Statement From the International Liaison Committee on Resuscitation (American Heart Association, Australian and New Zealand Council on Resuscitation, European Resuscitation Council, Heart and Stroke Foundation of Canada, InterAmerican Heart Foundation, Resuscitation Council of Asia, and the Resuscitation Council of Southern Africa); the American Heart Association Emergency Cardiovascular Care Committee; the Council on Cardiovascular Surgery and Anesthesia; the Council on Cardiopulmonary, Perioperative, and Critical Care; the Council on Clinical Cardiology; and the Stroke Council Circulation, December 2, 2008; 118(23): 2452 - 2483. [Full Text] [PDF]
|
|
|
|
 |
|
 M. Yenari, K. Kitagawa, P. Lyden, and M. Perez-Pinzon Metabolic Downregulation: A Key to Successful Neuroprotection? Stroke, October 1, 2008; 39(10): 2910 - 2917. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 B. P. Meloni, F. L. Mastaglia, and N. W. Knuckey Review: Therapeutic applications of hypothermia in cerebral ischaemia Therapeutic Advances in Neurological Disorders, September 1, 2008; 1(2): 75 - 98. [Abstract] [PDF]
|
|
|
|
 |
|
 H. B. van der Worp, E. S. Sena, G. A. Donnan, D. W. Howells, and M. R. Macleod Hypothermia in animal models of acute ischaemic stroke: a systematic review and meta-analysis Brain, December 1, 2007; 130(12): 3063 - 3074. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. A Rabinstein and K. Sandhu Non-infectious fever in the neurological intensive care unit: incidence, causes and predictors J. Neurol. Neurosurg. Psychiatry, November 1, 2007; 78(11): 1278 - 1280. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. Bardutzky and S. Schwab Antiedema Therapy in Ischemic Stroke Stroke, November 1, 2007; 38(11): 3084 - 3094. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. Kollmar and S. Schwab Ischaemic stroke: acute management, intensive care, and future perspectives Br. J. Anaesth., July 1, 2007; 99(1): 95 - 101. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. P. Adams Jr, G. del Zoppo, M. J. Alberts, D. L. Bhatt, L. Brass, A. Furlan, R. L. Grubb, R. T. Higashida, E. C. Jauch, C. Kidwell, et al. Guidelines for the Early Management of Adults With Ischemic Stroke: A Guideline From the American Heart Association/American Stroke Association Stroke Council, Clinical Cardiology Council, Cardiovascular Radiology and Intervention Council, and the Atherosclerotic Peripheral Vascular Disease and Quality of Care Outcomes in Research Interdisciplinary Working Groups: The American Academy of Neurology affirms the value of this guideline as an educational tool for neurologists. Circulation, May 22, 2007; 115(20): e478 - e534. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. P. Adams Jr, G. del Zoppo, M. J. Alberts, D. L. Bhatt, L. Brass, A. Furlan, R. L. Grubb, R. T. Higashida, E. C. Jauch, C. Kidwell, et al. Guidelines for the Early Management of Adults With Ischemic Stroke: A Guideline From the American Heart Association/ American Stroke Association Stroke Council, Clinical Cardiology Council, Cardiovascular Radiology and Intervention Council, and the Atherosclerotic Peripheral Vascular Disease and Quality of Care Outcomes in Research Interdisciplinary Working Groups: The American Academy of Neurology affirms the value of this guideline as an educational tool for neurologists Stroke, May 1, 2007; 38(5): 1655 - 1711. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. M. Hemmen and P. D. Lyden Induced Hypothermia for Acute Stroke Stroke, February 1, 2007; 38(2): 794 - 799. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
Part 9: Adult Stroke Circulation, December 13, 2005; 112(24_suppl): IV-111 - IV-120. [Full Text] [PDF]
|
|
|
|
|
|
C. A. Molina and J. L. Saver Extending Reperfusion Therapy for Acute Ischemic Stroke: Emerging Pharmacological, Mechanical, and Imaging Strategies Stroke, October 1, 2005; 36(10): 2311 - 2320. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 X.-F. Yang, Y. Ouyang, B. R Kennedy, and S. M Rothman Cooling blocks rat hippocampal neurotransmission by a presynaptic mechanism: observations using 2-photon microscopy J. Physiol., August 15, 2005; 567(1): 215 - 224. [Abstract] [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
