Hypothermia during Carotid Endarterectomy: A Safety Study |
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| Authors: | Serena Candela Raffaele Dito Barbara Casolla Emanuele Silvestri Giuliano Sette Federico Filippi Maurizio Taurino Domitilla Brancadoro Francesco Orzi |
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| Institution: | 1NESMOS (Neurosciences Mental Health and Sensory Organs) Department, School of Medicine and Psychology, Sapienza University, Sant''Andrea Hospital, Rome, Italy;2Cardiothoracic Vascular Sciences Department, School of Medicine and Psychology, Sapienza University, Sant''Andrea Hospital, Rome, Italy;3Surgical Anesthetic Sciences Department; School of Medicine and Psychology, Sapienza University, Sant''Andrea Hospital, Rome, Italy;Sapienza University of Rome, ITALY |
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| Abstract: | BackgroundCEA is associated with peri-operative risk of brain ischemia, due both to emboli production caused by manipulation of the plaque and to potentially noxious reduction of cerebral blood flow by carotid clamping. Mild hypothermia (34–35°C) is probably the most effective approach to protect brain from ischemic insult. It is therefore a substantial hypothesis that hypothermia lowers the risk of ischemic brain damage potentially associated with CEA. Purpose of the study is to test whether systemic endovascular cooling to a target of 34.5–35°C, initiated before and maintained during CEA, is feasible and safe.MethodsThe study was carried out in 7 consecutive patients referred to the Vascular Surgery Unit and judged eligible for CEA. Cooling was initiated 60–90 min before CEA, by endovascular approach (Zoll system). The target temperature was maintained during CEA, followed by passive, controlled rewarming (0.4°C/h). The whole procedure was carried out under anesthesia.ResultsAll the patients enrolled had no adverse events. Two patients exhibited a transient bradycardia (heart rate 30 beats/min). There were no significant differences in the clinical status, laboratory and physiological data measured before and after CEA.ConclusionsSystemic cooling to 34.5–35.0°C, initiated before and maintained during carotid clamping, is feasible and safe.Trial RegistrationClinicalTrials.gov {"type":"clinical-trial","attrs":{"text":"NCT02629653","term_id":"NCT02629653"}}NCT02629653 |
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