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Ventriculo-lumbar perfusion in acute ischemic stroke
Rodney D Bell1, Barbara L Powers, David Brock
1Thomas Jefferson University Medical College, Department of Neurology, Philadelphia, PA 19107, USA. rodney.bell@jefferson.edu
Neurocritical Care
|September 9, 2006
Summary
This pilot study shows that ventriculo-lumbar perfusion using oxygenated fluorocarbon nutrient emulsion is a safe and feasible method for treating severe ischemic stroke patients. The novel approach successfully delivered nutrients and oxygen to the brain.
Area of Science:
- Neurology
- Biomedical Engineering
- Neurosurgery
Background:
- Severe ischemic stroke remains a significant unmet medical need.
- Nonvascular pathways, such as the paravascular cerebrospinal fluid route, offer a potential treatment strategy.
- This study investigates a novel perfusion system for delivering oxygen and nutrients to ischemic brain tissue.
Purpose of the Study:
- To evaluate the safety and technical feasibility of ventriculo-lumbar perfusion.
- To assess the use of an oxygenated fluorocarbon nutrient emulsion (OFNE) perfusion system.
- To treat patients with severe hemispheric cerebral ischemia.
Main Methods:
- A pilot study involving four patients with severe ischemic stroke.
- Establishment of a ventriculo-lumbar perfusion pathway.
- Perfusion of OFNE over a 24-hour period with monitoring of intracranial pressure (ICP).
Main Results:
- The perfusion pathway was successfully established in all four patients.
- Perfusion rates ranged from 25-40 mL/minute, with total volumes of 30.6-45.8 L over 24 hours.
- Intracranial pressure was managed effectively (-3 to 16 mmHg), and no serious adverse events occurred.
Conclusions:
- Establishing a ventriculo-lumbar perfusion pathway is technically feasible and safe.
- A specially designed lumbar drainage catheter facilitates the procedure.
- Large volumes of OFNE can be safely perfused while controlling intracranial pressure.
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