Use of an epidural cooling catheter with a closed countercurrent lumen to protect against ischemic spinal cord injury in pigs

Akihiro Yoshitake, Atsuo Mori, Hideyuki Shimizu, Toshihiko Ueda, Nobuyuki Kabei, Takashi Hachiya, Hideyuki Okano, Ryohei Yozu

Research output: Contribution to journalArticle

24 Citations (Scopus)

Abstract

Objective: We developed an epidural cooling catheter containing cold saline solution circulating in an isolated lumen. After placement by a minimally invasive approach, we evaluated protection effect against ischemic spinal cord injury in pigs. Methods: Fourteen pigs underwent thoracic aortic double clamping for 45 minutes under systemic mild hypothermia (36°C). Group A (n = 7) underwent local hypothermia with the cooling catheter. Group B (n = 7) underwent catheter placement only, without cooling. Spinal cord somatosensory evoked potentials were recorded to assess electrophysiologic status. Neurologic function was evaluated with a modified Tarlov score. Results: At aortic crossclamping, spinal temperature in group A (26.5°C ± 2.4°C) was significantly lower than that in group B (35.3°C ± 0.6°C, P = .0001). Mean time from aortic crossclamping to onset of potential loss was significantly longer in group A (28.4 ± 6.6 minutes) than in group B (18.3 ± 5.0 minutes, P = .007). Mean duration of total loss of potentials was significantly shorter in group A (19.0 ± 6.7 minutes) than that in group B (31.3 ± 5.9 minutes, P = .003). Group A showed significantly better neurologic function (mean Tarlov score 4.4 ± 0.8) than that of group B (0.1 ± 0.4, P = .0001). Mean total number of intact motor neurons was significantly greater in group A (24.5 ± 6.8) than that of group B (9.9 ± 6.8, P = .0001). Conclusion: By cooling the spinal cord selectively and continuously, the newly designed epidural cooling catheter prevented ischemic injury in a pig model of aortic crossclamping.

Original languageEnglish
Pages (from-to)1220-1226
Number of pages7
JournalJournal of Thoracic and Cardiovascular Surgery
Volume134
Issue number5
DOIs
Publication statusPublished - 2007 Nov
Externally publishedYes

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery

Cite this

Use of an epidural cooling catheter with a closed countercurrent lumen to protect against ischemic spinal cord injury in pigs. / Yoshitake, Akihiro; Mori, Atsuo; Shimizu, Hideyuki; Ueda, Toshihiko; Kabei, Nobuyuki; Hachiya, Takashi; Okano, Hideyuki; Yozu, Ryohei.

In: Journal of Thoracic and Cardiovascular Surgery, Vol. 134, No. 5, 11.2007, p. 1220-1226.

Research output: Contribution to journalArticle

Yoshitake, Akihiro ; Mori, Atsuo ; Shimizu, Hideyuki ; Ueda, Toshihiko ; Kabei, Nobuyuki ; Hachiya, Takashi ; Okano, Hideyuki ; Yozu, Ryohei. / Use of an epidural cooling catheter with a closed countercurrent lumen to protect against ischemic spinal cord injury in pigs. In: Journal of Thoracic and Cardiovascular Surgery. 2007 ; Vol. 134, No. 5. pp. 1220-1226.
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abstract = "Objective: We developed an epidural cooling catheter containing cold saline solution circulating in an isolated lumen. After placement by a minimally invasive approach, we evaluated protection effect against ischemic spinal cord injury in pigs. Methods: Fourteen pigs underwent thoracic aortic double clamping for 45 minutes under systemic mild hypothermia (36°C). Group A (n = 7) underwent local hypothermia with the cooling catheter. Group B (n = 7) underwent catheter placement only, without cooling. Spinal cord somatosensory evoked potentials were recorded to assess electrophysiologic status. Neurologic function was evaluated with a modified Tarlov score. Results: At aortic crossclamping, spinal temperature in group A (26.5°C ± 2.4°C) was significantly lower than that in group B (35.3°C ± 0.6°C, P = .0001). Mean time from aortic crossclamping to onset of potential loss was significantly longer in group A (28.4 ± 6.6 minutes) than in group B (18.3 ± 5.0 minutes, P = .007). Mean duration of total loss of potentials was significantly shorter in group A (19.0 ± 6.7 minutes) than that in group B (31.3 ± 5.9 minutes, P = .003). Group A showed significantly better neurologic function (mean Tarlov score 4.4 ± 0.8) than that of group B (0.1 ± 0.4, P = .0001). Mean total number of intact motor neurons was significantly greater in group A (24.5 ± 6.8) than that of group B (9.9 ± 6.8, P = .0001). Conclusion: By cooling the spinal cord selectively and continuously, the newly designed epidural cooling catheter prevented ischemic injury in a pig model of aortic crossclamping.",
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AU - Kabei, Nobuyuki

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