WFITN 2019: Selective brain cooling could benefit “fast progressing” ischaemic stroke patients

Waleed Brinjikji talks to BLearning Neuro at WFITN 2019 (World Federation of Interventional and Therapeutic Neuroradiology; 21–24 October, Naples, Italy) about his presentation on selective brain cooling, a process where the internal carotid artery or the middle cerebral artery are cooled by either infusing cold saline via a catheter or using “extremely cold water” in the airway and thus cooling the arteries which are in close proximity.

Brinjikji explains that there are two main populations of ischaemic stroke patients, slow progressors and fast progressors–the latter being those where “you do not have long to save the brain” and who are also the most likely to benefit from selective cooling. Brinjikji also touches upon the risks associated with the procedure such as coagulopathies and aspiration from the airway cooling which “can result in some significant medical problems”.

He also touches upon recent small studies using the catheter-based cooling of the internal carotid artery which showed that the procedure is “generally pretty safe”. However, despite a “large body of evidence that cooling has the potential to really benefit stroke patients”, Brinjikji believes there are “many unanswered questions” that need to be addressed before clinical trials can begin.

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