Impact of immediate post-reperfusion cooling on outcome in patients with acute stroke and substantial ischemic changes

Yang Ha Hwang, Ji Su Jeon, Yong Won Kim, Dong Hun Kang, Yong Sun Kim, David S. Liebeskind

Research output: Contribution to journalArticlepeer-review

20 Scopus citations

Abstract

Background: In patients with acute stroke and an extensive ischemic burden at baseline, the prognosis is usually poor despite timely reperfusion. Objective To overcome universally poor outcomes in such patients, by applying immediate 'post-reperfusion cooling' in order to reduce reperfusion-related complications, and to describe the clinical and imaging characteristics. Methods: Patients having (1) an acute anterior large vessel occlusive stroke within 4.5 h since last known well, (2) Alberta Stroke Program Early CT Score (ASPECTS) ≤5 on baseline imaging, and (3) targeted temperature management with endovascular cooling after confirmed reperfusion were included in this study. Results: Eighteen patients (mean±SD age 59.5 ±10.9 years, median National Institutes of Health Stroke Scale score of 17, and median ASPECTS of 3) were analyzed. Median lesion volumes at baseline and after treatment were 130.2 and 110.6 mL, respectively. Median time from onset to the start of hypothermia and hypothermia duration were 213 min and 51 h, respectively. Favorable outcome (modified Rankin Scale ≤2) at 3 months was observed in 10 (55.6%) patients. Symptomatic intracranial hemorrhage, malignant brain edema, and pneumonia were observed in 2, 6, and 8 patients, respectively. Conclusions: The use of post-reperfusion cooling as a rescue treatment in patients with substantial ischemia at baseline might improve clinical outcome.

Original languageEnglish
Pages (from-to)21-25
Number of pages5
JournalJournal of NeuroInterventional Surgery
Volume9
Issue number1
DOIs
StatePublished - 2017

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