Introduction: The aim of this study was to discuss the safety of rapid administration of 4°C hypothermic normal saline into the occluded vessels using an intra-arterial catheter to induce mild hypothermia following endovascular thrombectomy in patients with acute large vessel occlusion cerebral infarction. Methods: We selected 78 patients with acute large vessel occlusion cerebral infarction who underwent endovascular thrombectomy in the Department of Neurology of our hospital from January 2020 to July 2022 and achieved TICI 2b recanalization. Result: Twenty-five patients were administered 500 mL of 4°C hypothermic normal saline in the occluded vessels at a rate of 25 mL/min to induce mild hypothermia. Twenty pairs of subjects conformed to strict matching and were finally included in the statistical analysis. The two groups of patients differed significantly in white blood cell count and percentage of neutrophils (p < 0.05); however, there were no significant differences in D-dimer, procalcitonin, and BNP levels. The two groups of patients did not differ significantly with respect to the incidence of the following indicators: upper gastrointestinal bleeding; pulmonary infection; venous thrombosis; vasospasms; seizures; and chills (p > 0.05). Conclusion: Mild therapeutic hypothermia in target vessels plus endovascular thrombectomy was shown to be safe in patients with acute large vessel occlusion cerebral infarction.

1.
Compilation group for Chinese stroke prevention and treatment report. Abstract of Chinese stroke prevention and treatment report 2020
.
Chin J Cerebrovasc Dis
.
2022
;
19
(
12
):
136
45
.
2.
Liu
XF
.
Open a new era of early diagnosis and treatment of acute great vascular occlusive stroke
.
Chin J Neurol
.
2015
;
48
(
5
):
353
5
.
3.
Tsang
ACO
,
You
J
,
Li
LF
,
Tsang
FCP
,
Woo
PPS
,
Tsui
ELH
.
Burden of large vessel occlusion stroke and the service gap of thrombectomy: a population-based study using a territory-wide public hospital system registry
.
Int J Stroke
.
2020
;
15
(
1
):
69
74
.
4.
Mohan
KM
,
Wolfe
CD
,
Rudd
AG
,
Heuschmann
PU
,
Kolominsky-Rabas
PL
,
Grieve
AP
.
Risk and cumulative risk of stroke recurrence: a systematic review and meta-analysis
.
Stroke
.
2011
;
42
(
5
):
1489
94
.
5.
Campbell
BC
,
Mitchell
PJ
,
Kleinig
TJ
,
Dewey
HM
,
Churilov
L
,
Yassi
N
.
Endovascular therapy for ischemic stroke with perfusion-imaging selection
.
N Engl J Med
.
2015
;
372
(
11
):
1009
18
.
6.
Goyal
M
,
Demchuk
AM
,
Menon
BK
,
Eesa
M
,
Rempel
JL
,
Thornton
J
.
Randomized assessment of rapid endovascular treatment of ischemic stroke
.
N Engl J Med
.
2015
;
372
(
11
):
1019
30
.
7.
Berkhemer
OA
,
Fransen
PS
,
Beumer
D
,
van den Berg
LA
,
Lingsma
HF
,
Yoo
AJ
.
A randomized trial of intraarterial treatment for acute ischemic stroke
.
N Engl J Med
.
2015
;
372
(
1
):
11
20
.
8.
Saver
JL
,
Goyal
M
,
Bonafe
A
,
Diener
HC
,
Levy
EI
,
Pereira
VM
.
Stent-retriever thrombectomy after intravenous t-PA vs. t-PA alone in stroke
.
N Engl J Med
.
2015
;
372
(
24
):
2285
95
.
9.
Jovin
TG
,
Chamorro
A
,
Cobo
E
,
de Miquel
MA
,
Molina
CA
,
Rovira
A
.
Thrombectomy within 8 h after symptom onset in ischemic stroke
.
N Engl J Med
.
2015
;
372
(
24
):
2296
306
.
10.
Albers
GW
,
Marks
MP
,
Kemp
S
,
Christensen
S
,
Tsai
JP
,
Ortega-Gutierrez
S
.
Thrombectomy for stroke at 6 to 16 h with selection by perfusion imaging
.
N Engl J Med
.
2018
;
378
(
8
):
708
18
.
11.
Nogueira
RG
,
Jadhav
AP
,
Haussen
DC
,
Bonafe
A
,
Budzik
RF
,
Bhuva
P
.
Thrombectomy 6 to 24 h after stroke with a mismatch between deficit and infarct
.
N Engl J Med
.
2018
;
378
(
1
):
11
21
.
12.
Li
J
,
Benashski
S
.
Poststroke hypothermia provides neur protection through inhibition of AMP: activated protein kinase
.
J Neurotrauma
.
2011
28
7
128l
8
.
13.
Zhang
H
,
Zhang
JJ
,
Mei
YW
,
Sun
SG
,
Tong
ET
.
Effects of immediate and delayed mild hypothermia on endogenous antioxidant enzymes and energy metabolites following global cerebral ischemia
.
Chin Med J
.
2011
;
124
(
17
):
2764
6
.
14.
Deng
H
,
Han
HS
,
Cheng
D
,
Sun
GH
,
Yenari
MA
.
Mild hypothermia inhibits inflammation after experimental stroke and brain inflammation
.
Stroke
.
2003
;
34
(
10
):
2495
501
.
15.
Esposito
E
,
Ebner
M
,
Ziemann
U
,
Poli
S
.
In cold blood: intraarteral cold infusions for selective brain cooling in stroke
.
J Cereb Blood Flow Metab
.
2014
;
34
(
5
):
743
52
.
16.
Chen
J
,
Liu
L
,
Zhang
H
,
Geng
X
,
Jiao
L
,
Li
G
.
Endovascular hypothermia in acute ischemic stroke: pilot study of selective intra-arterial cold saline infusion
.
Stroke
.
2016
;
47
(
7
):
1933
5
.
17.
Felberg
RA
,
Krieger
DW
,
Chuang
R
,
Persse
DE
,
Burgin
WS
,
Hickenbottom
SL
.
Hypothermia after cardiac arrest: feasibility and safety of an external cooling protocol
.
Circulation
.
2001
;
104
(
15
):
1799
804
.
18.
Wu
DS
,
Guo
J
,
Qi
BQ
,
Xiao
H
.
Effects of mild hypothermia treatment on the infection and prognosis in patients following acute ischemic stroke
.
J Wannan Med Coll
.
2009
;
37
(
3
):
1101
20
.
19.
Xu
WW
,
Ding
XQ
.
Effects of transcatheter selective intracerebral interventional embolization combined with mild hypothermia at different time on the clinical efficacy, neurological function and stress response of acute cerebral infarction
.
Med Pharm J Chin People’s Lib Army
.
2020
;
32
(
11
):
84
5
.
20.
Lu
ZQ
,
Liu
LJ
.
Significance of procalcitonin and C-reactive protein in guiding antibacterial treatment of neonatal bacterial infection during mild hypothermia
.
Jilin Med J
.
2017
;
38
(
7
):
1311
2
.
21.
Zhou
N
,
Lai
J
,
Jiang
L
,
Hu
J
,
Pan
Y
,
Tang
Z
.
Mild hypothermia can delay the occurrence of post-stroke infection:a propensity score matched-cohort study
.
Chin Crit Care Med
.
2019
;
31
(
12
):
1435
9
.
22.
Ma
C
,
Cao
J
,
Zhang
N
,
Liu
W
,
Sun
L
,
Wang
Y
.
Relative risk factors and prognosis analysis of lower-limb DVT in neurology intensive care unit
.
J Apoplexy Nerv Dis
.
2015
;
32
(
6
):
544
6
.
23.
Shao
XM
.
Safety of selective head cooling with mild systemic hypothermia after neonatal encephalopathy: multicentre randomized trial
.
Chin J Evid Based Pediatr
.
2006
;
1
(
1
):
20
5
.
24.
Bücke
P
,
Hellstern
V
,
Cimpoca
A
,
Cohen
JE
,
Horvath
T
,
Ganslandt
O
.
Endovascular treatment of intracranial vein and venous sinus thrombosis-A systematic review
.
J Clin Med
.
2022
;
11
(
14
):
4215
.
25.
Xiao
W
.
Clinical randomized controlled study of mild hypothermia combined with minimally invasive removal of intracranial hematoma in treatment of severe hypertensive intracerebral hemorrhage
.
Med Innovation China
.
2017
;
14
(
5
):
31
5
.
26.
Zhou
SC
.
Safety and brain protection of mild hypothermia and persistent state conventional therapy for epileptic status
.
Heilongjiang Med Pharm
.
2018
;
41
(
1
):
146
7
.
27.
Zhou
Y
,
Liu
C
,
Yang
G
,
Yu
D
,
Zhou
L
,
Liu
X
.
Effect and mechanism of intravascular mild hypothermia on abnormal neuronal discharge in rats with cerebral ischemic epilepsy
.
Shandong Med J
.
2018
;
58
(
21
):
41
4
.
28.
Peng
Y
,
Liu
H
,
Wang
B
.
Mild hypothermia combined with intravenous thrombolytic therapy can improve cognitive functioning and stress response after cerebral infarction
.
Chin J Phys Med Rehabil
.
2019
;
41
(
3
):
184
8
.
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