Abstract
Objective Herein, we evaluated the efficacy and safety of intra-arterial mild hypothermia in combination with arterial thrombolysis to treat acute cerebral infarction due to middle cerebral artery occlusion.MethodsA total of 26 patients with acute middle cerebral artery occlusion were divided into a normothermia group (n = 15) and a mild hypothermia group (n = 11). The infarct volumes at 24 h and 7 days after the operation were compared between the normothermia group and the mild hypothermia group. Additionally, we compared neurological deficit scores between the two groups at 24 h, 7 days, and 1 mo after the operation.ResultsThe infarct volumes and neurological deficit scores of the mild hypothermia group were significantly reduced compared to those in the normothermia group (p < 0.05). Furthermore, no adverse reactions or complications occurred in the mild hypothermia group.ConclusionIntra-arterial mild hypothermia reduced infarct volume after ischemia–reperfusion injury in the arterial thrombolysis of an acute cerebral infarction. Additionally, it improved the prognosis of patients with an acute middle cerebral artery occlusion, suggesting that this procedure is safe and effective for treating acute cerebral infarction.
Highlights
Ischemic cerebrovascular disease, which is otherwise known as a stroke, is the second leading global cause of mortality after coronary heart disease and a major cause of neurological disability (Lopez et al 2006)
Infarct volumes after induced intra‐arterial mild hypothermia The representative magnetic resonance imaging (MRI) were presented in the normothermia group and mild hypothermia group (Fig. 1)
The neurological scores in the mild hypothermia group prominently improved at 24 h, 7 days, and 1 mo after the operation compared with those scores in the normothermia group (p < 0.05; Table 2)
Summary
Ischemic cerebrovascular disease, which is otherwise known as a stroke, is the second leading global cause of mortality after coronary heart disease and a major cause of neurological disability (Lopez et al 2006). Ischemic cerebrovascular disease that involves an acute middle cerebral artery occlusion is associated with higher rates of disability and mortality (Gawlitza et al 2016). For such a condition, early stage intravenous thrombolysis is performed (The National Institute of Neurological Disorders and Stroke rt-PA Stroke Study Group 1995) and the drug alteplase, a tissue plasminogen activator, is administered (Campbell et al 2015a). This is the only therapy with a proven efficacy for acute ischemic stroke when used within 3–5 h after stroke onset (Fisher and Saver 2015). Because of the complexity of intravenous thrombolysis (Shao et al 2015), little improvement has been made in the use of thrombolysis procedures for acute stroke (Marshall 2015)
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