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急性缺血性卒中的血管内低温治疗:选择性动脉内冷盐水输注的初步研究。

Endovascular Hypothermia in Acute Ischemic Stroke: Pilot Study of Selective Intra-Arterial Cold Saline Infusion.

作者信息

Chen Jian, Liu Liqiang, Zhang Hongqi, Geng Xiaokun, Jiao Liqun, Li Guilin, Coutinho Jonathan M, Ding Yuchuan, Liebeskind David S, Ji Xunming

机构信息

From the Department of Neurosurgery (J.C., L.L., H.Z., X.G., G.L., X.J.) and Interventional Radiology (L.J.), Xuanwu Hospital, Capital Medical University, Beijing, China; Department of Neurological Surgery, Wayne State University School of Medicine, Detroit, MI (Y.D.); Department of Neurology, David Geffen School of Medicine, University of California Los Angeles Stroke Center (D.S.L.); and Department of Neurology, Academic Medical Center, University of Amsterdam, The Netherlands (J.M.C.).

出版信息

Stroke. 2016 Jul;47(7):1933-5. doi: 10.1161/STROKEAHA.116.012727. Epub 2016 May 19.

Abstract

BACKGROUND AND PURPOSE

We conducted a pilot feasibility and safety study of selective brain cooling with intra-arterial infusion of cold saline combined with endovascular reperfusion for acute ischemic stroke.

METHODS

Patients with large-vessel occlusion within 8 hours after symptom onset were enrolled. All patients received intra-arterial recanalization combined with infusion of cold isotonic saline (4°C) in the ischemic territory through the angiographic catheter.

RESULTS

Twenty-six patients underwent the procedure, which was technically successful in all. The temperature of ischemic cerebral tissue was decreased by at least 2°C during infusion of the cold solution, and systemic temperature was mildly reduced (maximum 0.3°C). No obvious complications related to intra-arterial hypothermia were observed.

CONCLUSIONS

Selective brain cooling by intra-arterial infusion of cold saline combined with endovascular recanalization therapy in acute ischemic stroke seems feasible and safe.

摘要

背景与目的

我们开展了一项关于急性缺血性卒中选择性脑冷却的初步可行性与安全性研究,采用动脉内输注冷盐水联合血管内再灌注治疗。

方法

纳入症状发作后8小时内出现大血管闭塞的患者。所有患者均接受动脉内再通治疗,并通过血管造影导管在缺血区域输注冷等渗盐水(4°C)。

结果

26例患者接受了该手术,技术上均获成功。在输注冷溶液期间,缺血脑组织温度至少降低了2°C,全身温度略有降低(最大0.3°C)。未观察到与动脉内低温相关的明显并发症。

结论

急性缺血性卒中采用动脉内输注冷盐水联合血管内再通治疗进行选择性脑冷却似乎是可行且安全的。

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