Abstract Details

Title Shivering Control in the Angiography Suite Is Feasible and Safe for Patients Undergoing Simultaneous Intra-Arterial Thrombectomy and Endovenous Hypothermia under Conscious Sedation

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P06 - (-)

Poster/Presentation
Number 251

Objective

Background BACKGROUND: Hypothermia is a powerful neuroprotectant and may diminish reperfusion injury after recanalization in patients with AIS. Due to easy access to the femoral vein, endovenous hypothermia (EH) can be easily combined with IAT.

Design/Methods DESIGN/METHODS: All consecutive patients undergoing combined IAT and EH under conscious sedation were studied. An arterial sheath and an EH catheter were placed into the femoral artery and vein. Hypothermia induction was performed with cold saline infusion with goal temperature prior to reperfusion of ?35[deg] followed by 32[deg] for a total of 24 hours. Controlled rewarming at 0.2[deg]/hour was carried out. Antishivering therapy consisted of skin counter warming, dexmedetomidine, meperidine, buspirone, and magnesium. The bedside shivering assessment scale (BSAS) was used to monitor shivering.

Results RESULTS: A total of 13 patients underwent the hypothermia protocol. Median age was 67 (range 49-80), NIHSS 18 (12-27), time from last known well 5 hours (1-10), and ASPECTS 7 (6-10). Eight patients reached 35[deg] prior to recanalization. The median time to reach 32[deg] was 171 minutes (122-235). Median dose of dexmedetomidine infusion was 0.5 mcg/kg (0.2-0.8), meperidine 25mg (0-75), and magnesium 4g (4-6). Median BSAS was 1 (0-3) and RASS -2 (-4 to +3). No symptomatic bradycardia was recorded, and median HR was 72 (59-87) with MAP of 84 (61-126). No patient required mechanical ventilation due to sedation. No episodes of aspiration or seizures were recorded. All patients tolerated hypothermia and achieved shivering control without early termination of the hypothermia therapy.

Conclusions CONCLUSIONS: Shivering control in the angiography suite can be safely achieved and is well tolerated by utilizing physical and pharmacological strategies. Significant cardiovascular or respiratory complications were not encountered.

Authors/Disclosures
Edilberto Amorim, MD PRESENTER	The institution of Dr. Amorim has received research support from American Heart Association. The institution of Dr. Amorim has received research support from Society of Critical Care Medicine. The institution of Dr. Amorim has received research support from Zoll Foundation. The institution of Dr. Amorim has received research support from Hellman Foundation. The institution of Dr. Amorim has received research support from Regents of the University of California. The institution of Dr. Amorim has received research support from Citizens United Against Epilepsy. The institution of Dr. Amorim has received research support from Regents of the University of California. The institution of Dr. Amorim has received research support from American Heart Association. The institution of Dr. Amorim has received research support from NIH. The institution of Dr. Amorim has received research support from Department of Defense. The institution of Dr. Amorim has received research support from Department of Defense. The institution of Dr. Amorim has received research support from American Heart Association.
	No disclosure on file
Ashutosh P. Jadhav, MD, FAAN (Barrow Neurological Institute)	Dr. Jadhav has nothing to disclose.
	No disclosure on file
	No disclosure on file
	No disclosure on file
Lawrence R. Wechsler, MD, FAAN (UPMC)	Dr. Wechsler has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for American Neurological Association. Dr. Wechsler has stock in Forest Devices.
Tudor G. Jovin, MD (Cooper University Healthcare)	Dr. Jovin has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Cerenovus. Dr. Jovin has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Contego Medical. Dr. Jovin has received personal compensation in the range of $5,000-$9,999 for serving as an Expert Witness for Several law firms. Dr. Jovin has stock in Corindus. Dr. Jovin has stock in Methinks. Dr. Jovin has stock in Viz.ai. Dr. Jovin has stock in Route92. Dr. Jovin has stock in FreeOx Biotech. Dr. Jovin has stock in Galaxy. Dr. Jovin has stock in Kandu. The institution of Dr. Jovin has received research support from Stryker. The institution of Dr. Jovin has received research support from Medtronic.
	No disclosure on file
Guillermo Linares, MD	Dr. Linares has nothing to disclose.

��ɫ��

��ɫ��