Department of Neurology & Stroke, Eberhard-Karls University of Tübingen, Tübingen, Germany.
Hertie-Institute for Clinical Brain Research, Eberhard-Karls University of Tübingen, Tübingen, Germany.
Transl Stroke Res. 2021 Aug;12(4):676-687. doi: 10.1007/s12975-020-00848-3. Epub 2020 Sep 10.
Intra-carotid cold infusion (ICCI) appears as a promising method for hypothermia-mediated brain protection from ischemic stroke. Recent clinical pilot studies indicate easy implementation of ICCI into endovascular acute ischemic stroke treatment. Current rodent ICCI-in-stroke models limit ICCI to the post-reperfusion phase. To establish a method for continuous ICCI over the duration of intra-ischemia to post-reperfusion in rodent stroke models, a novel system was developed. Eighteen male Sprague-Dawley rats were included. Intraluminal filament method was used for transient middle cerebral artery occlusion (MCAO). Normal saline (~ 0 °C) was delivered (≤ 2.0 mL/min) into the internal carotid artery via a customized infusion system without interruption during MCAO (intra-ischemia) to after filament withdrawal (post-reperfusion). Bilateral cortical and striatal temperatures were monitored. Hypothermia goals were a temperature reduction in the ischemic hemisphere by 2 °C prior to reperfusion and thereafter maintenance of regional brain hypothermia at ~ 32 °C limiting the administered ICCI volume to ½ of each rat's total blood volume. During ischemia, maximum brain cooling rate was achieved with ICCI at 0.5 mL/min. It took 2 min to reduce ischemic striatal temperature by 2.3 ± 0.3 °C. After reperfusion, brain cooling was continued at 2 mL/min ICCI first (over 42 s) and maintained at 32.1 ± 0.3 °C at 0.7 mL/min ICCI over a duration of 15 ± 0.8 min. ICCI (total 12.6 ± 0.6 mL) was uninterrupted over the duration of the studied phases. First system that allows continuous ICCI during the phases of intra-ischemia to post-reperfusion in small animals for selective brain cooling and for investigations of other neuroprotective infusions.
颈内冷输注 (ICCI) 似乎是一种有前途的方法,可以通过低温介导对缺血性中风的脑保护。最近的临床初步研究表明,将 ICCI 很容易应用于血管内急性缺血性中风的治疗中。目前的啮齿动物 ICCI-中风模型将 ICCI 限制在再灌注后阶段。为了在啮齿动物中风模型中建立一个在缺血期到再灌注期内持续进行 ICCI 的方法,开发了一种新的系统。纳入了 18 只雄性 Sprague-Dawley 大鼠。使用管腔内线栓法进行短暂性大脑中动脉闭塞 (MCAO)。通过定制的输注系统向颈内动脉内输注生理盐水(0°C)(≤2.0mL/min),在 MCAO(缺血期)期间不间断输注,直至线栓取出后(再灌注期)。监测双侧皮质和纹状体的温度。低温目标是在再灌注前使缺血半球的温度降低 2°C,然后将局部脑低温维持在32°C,将输注的 ICCI 量限制在每只大鼠总血容量的一半。在缺血期间,以 0.5mL/min 的 ICCI 实现了最大的脑冷却速率。将缺血纹状体温度降低 2.3±0.3°C 需 2 分钟。再灌注后,以 2mL/min 的 ICCI 首先继续进行脑冷却(持续 42s),然后以 0.7mL/min 的 ICCI 持续 15±0.8min 维持在 32.1±0.3°C。ICCI(总共 12.6±0.6mL)在研究阶段内不间断输注。该系统首次允许在小型动物的缺血期到再灌注期内持续进行 ICCI,以进行选择性脑冷却和其他神经保护输注的研究。