| A new technique allowing prolonged temporary cerebral artery occlusion. | |
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MedLine Citation:
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PMID: 19035732 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECT: Clipping of complex cerebral aneurysms often requires temporary vessel occlusion. The risk of stroke, however, increases exponentially with occlusion time. The authors hypothesized that prolonged temporary occlusion might be tolerated if the occluded vessels were perfused with cold physiological saline solution (CPSS). A low-flow perfusion rate would permit surgical manipulation of an aneurysm distal to the occlusion. METHODS: To test this hypothesis, the authors temporarily occluded the middle cerebral artery (MCA) with an endovascular catheter in 6 rats. Three animals, the treatment group, were perfused with 5-ml CPSS/hour through the occluding endovascular catheter into the MCA, and the other 3 served as an ischemic control group. In both groups, the catheter was removed after 90 minutes of occlusion. The brain temperature was monitored with a stereotactically placed probe in the caudate-putamen in 2 separate experimental groups (11 animals). RESULTS: Magnetic resonance imaging perfusion scanning during vessel occlusion confirmed similar reduction of cerebral blood flow during MCA occlusion in both the simple-occlusion and perfusion-occlusion groups. Magnetic resonance imaging diffusion scans performed 24 hours after temporary occlusion revealed infarcts in the ischemic control group of 138.3 +/- 28.0 mm(3) versus 9.9 +/- 9.9 mm(3) in the cold saline group (p < 0.005). A focal cooling effect during perfusion with CPSS was demonstrated (p < 0.05). CONCLUSIONS: Prolonged temporary cerebral vessel occlusion can be tolerated using superselective CPSS perfusion through an occluding endovascular catheter into the ischemic territory. This technique could possibly be applied in neurosurgery practice to the management of complex intracranial aneurysms. |
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Authors:
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Erik F Hauck; Jingna Wei; Michael J Quast; Haring J W Nauta |
Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Journal of neurosurgery Volume: 109 ISSN: 0022-3085 ISO Abbreviation: J. Neurosurg. Publication Date: 2008 Dec |
Date Detail:
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Created Date: 2008-11-27 Completed Date: 2009-01-07 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0253357 Medline TA: J Neurosurg Country: United States |
Other Details:
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Languages: eng Pagination: 1127-33 Citation Subset: AIM; IM |
Affiliation:
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Division of Neurosurgery, University of Texas Medical Branch at Galveston, Texas, USA. erik.hauck@utsouthwestern.edu |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Animals Body Temperature / physiology Brain / physiology Cerebrovascular Disorders / physiopathology* Intracranial Aneurysm / surgery* Magnetic Resonance Imaging Male Middle Cerebral Artery / drug effects*, physiopathology* Models, Animal Perfusion Rats Rats, Sprague-Dawley Risk Factors Sodium Chloride / administration & dosage, pharmacology* Stroke / prevention & control Surgical Instruments* |
| Chemical | |
Reg. No./Substance:
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7647-14-5/Sodium Chloride |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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