New method for absolute spinal cord ischemia protection in rabbits

Objective This study aims to establish a superior procedure to prevent spinal cord damage after severe spinal cord ischemia during aortic surgery. We examined the synergistic effect of topical hypothermia of the spinal cord combined with radical scavenger infusion into the clamped segment of the aor...

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Veröffentlicht in:Journal of vascular surgery 2011-10, Vol.54 (4), p.1109-1116
Hauptverfasser: Herlambang, Bagus, MD, Orihashi, Kazumasa, MD, PhD, Mizukami, Taketomo, MD, PhD, Takahashi, Shinya, MD, PhD, Uchida, Naomichi, MD, PhD, Hiyama, Eiso, MD, PhD, Sueda, Taijiro, MD, PhD
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container_end_page 1116
container_issue 4
container_start_page 1109
container_title Journal of vascular surgery
container_volume 54
creator Herlambang, Bagus, MD
Orihashi, Kazumasa, MD, PhD
Mizukami, Taketomo, MD, PhD
Takahashi, Shinya, MD, PhD
Uchida, Naomichi, MD, PhD
Hiyama, Eiso, MD, PhD
Sueda, Taijiro, MD, PhD
description Objective This study aims to establish a superior procedure to prevent spinal cord damage after severe spinal cord ischemia during aortic surgery. We examined the synergistic effect of topical hypothermia of the spinal cord combined with radical scavenger infusion into the clamped segment of the aorta to prevent spinal cord damage in an animal model. Methods Spinal cord ischemia was induced in rabbits by clamping the aorta between the renal artery and aortic bifurcation for 30 minutes. Rabbits were divided into four groups of 16 each: group I, sham-operated; group II, edaravone (6 mL, 4°C, 1 mg/kg); group III, saline (6 mL, 4°C) with transvertebral cooling pads; group IV, edaravone (6 mL, 4°C, 1 mg/kg) and transvertebral cooling pads. Solutions were injected into the clamped segment of the aorta. Postoperative assessments included the Tarlov score, spinal cord histopathology, and measurement of malondialdehyde levels in the spinal cord tissue. Results At 48 hours after reperfusion, the mean Tarlov scores in groups I, II, III, and IV were 4.0, 1.5, 1.9, and 4.0, respectively. The mean number of normal motor neurons was significantly higher in groups I (54.1) and IV (53.7) than in groups II (32.8) and III (36.3; P < .001). The mean malondialdehyde level in groups I (19.8 nmol/mL) and IV (22.6 nmol/mL) was significantly lower than in groups II (64.8 nmol/mL) and III (60.9 nmol/mL; P < .001). At 168 hours after reperfusion, the mean Tarlov scores in groups I, II, III, and IV were 4.0, 1.1, 1.3, and 4.0, respectively. The mean number of normal motor neurons was significantly higher in groups I (52.9) and IV (50.8) than in groups II (22.4) and III (25.9; P < .001). The mean malondialdehyde level in groups I (20.7 nmol/mL) and IV (23.4 nmol/mL) was significantly lower than in groups II (68.9 nmol/mL) and III (61.6 nmol/mL; P < .001). Conclusion In a rabbit model with aortic clamping up to 30 minutes, which consistently produces complete paraplegia in rabbits, spinal cord damage was partially reduced by topical cooling with transvertebral cooling pads or the injection of edaravone into the clamped segment of aorta, but was more effectively protected by a combined use of these two strategies.
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We examined the synergistic effect of topical hypothermia of the spinal cord combined with radical scavenger infusion into the clamped segment of the aorta to prevent spinal cord damage in an animal model. Methods Spinal cord ischemia was induced in rabbits by clamping the aorta between the renal artery and aortic bifurcation for 30 minutes. Rabbits were divided into four groups of 16 each: group I, sham-operated; group II, edaravone (6 mL, 4°C, 1 mg/kg); group III, saline (6 mL, 4°C) with transvertebral cooling pads; group IV, edaravone (6 mL, 4°C, 1 mg/kg) and transvertebral cooling pads. Solutions were injected into the clamped segment of the aorta. Postoperative assessments included the Tarlov score, spinal cord histopathology, and measurement of malondialdehyde levels in the spinal cord tissue. Results At 48 hours after reperfusion, the mean Tarlov scores in groups I, II, III, and IV were 4.0, 1.5, 1.9, and 4.0, respectively. The mean number of normal motor neurons was significantly higher in groups I (54.1) and IV (53.7) than in groups II (32.8) and III (36.3; P &lt; .001). The mean malondialdehyde level in groups I (19.8 nmol/mL) and IV (22.6 nmol/mL) was significantly lower than in groups II (64.8 nmol/mL) and III (60.9 nmol/mL; P &lt; .001). At 168 hours after reperfusion, the mean Tarlov scores in groups I, II, III, and IV were 4.0, 1.1, 1.3, and 4.0, respectively. The mean number of normal motor neurons was significantly higher in groups I (52.9) and IV (50.8) than in groups II (22.4) and III (25.9; P &lt; .001). The mean malondialdehyde level in groups I (20.7 nmol/mL) and IV (23.4 nmol/mL) was significantly lower than in groups II (68.9 nmol/mL) and III (61.6 nmol/mL; P &lt; .001). Conclusion In a rabbit model with aortic clamping up to 30 minutes, which consistently produces complete paraplegia in rabbits, spinal cord damage was partially reduced by topical cooling with transvertebral cooling pads or the injection of edaravone into the clamped segment of aorta, but was more effectively protected by a combined use of these two strategies.</description><identifier>ISSN: 0741-5214</identifier><identifier>EISSN: 1097-6809</identifier><identifier>DOI: 10.1016/j.jvs.2011.04.043</identifier><identifier>PMID: 21890303</identifier><identifier>CODEN: JVSUES</identifier><language>eng</language><publisher>New York, NY: Mosby, Inc</publisher><subject><![CDATA[Animals ; Antipyrine - administration & dosage ; Antipyrine - analogs & derivatives ; Aorta - surgery ; Biological and medical sciences ; Biomarkers - metabolism ; Blood and lymphatic vessels ; Cardiology. Vascular system ; Combined Modality Therapy ; Constriction ; Disease Models, Animal ; Diseases of the aorta ; Free Radical Scavengers - administration & dosage ; Hypothermia, Induced ; Infusions, Intra-Arterial ; Malondialdehyde - metabolism ; Medical sciences ; Motor Neurons - drug effects ; Motor Neurons - pathology ; Neurologic Examination ; Neuroprotective Agents - administration & dosage ; Oxidative Stress - drug effects ; Paraplegia - prevention & control ; Rabbits ; Reperfusion Injury - metabolism ; Reperfusion Injury - pathology ; Reperfusion Injury - physiopathology ; Reperfusion Injury - prevention & control ; Severity of Illness Index ; Spinal Cord Ischemia - metabolism ; Spinal Cord Ischemia - pathology ; Spinal Cord Ischemia - physiopathology ; Spinal Cord Ischemia - prevention & control ; Surgery ; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases ; Time Factors ; Vascular surgery: aorta, extremities, vena cava. Surgery of the lymphatic vessels ; Vascular Surgical Procedures - adverse effects]]></subject><ispartof>Journal of vascular surgery, 2011-10, Vol.54 (4), p.1109-1116</ispartof><rights>Society for Vascular Surgery</rights><rights>2011 Society for Vascular Surgery</rights><rights>2015 INIST-CNRS</rights><rights>Copyright © 2011 Society for Vascular Surgery. Published by Mosby, Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c546t-64bcea7067c881e67e3ad6603ba04ca47b7f42c5b223c21dcf2e8a7e5ac3e0483</citedby><cites>FETCH-LOGICAL-c546t-64bcea7067c881e67e3ad6603ba04ca47b7f42c5b223c21dcf2e8a7e5ac3e0483</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.jvs.2011.04.043$$EHTML$$P50$$Gelsevier$$Hfree_for_read</linktohtml><link.rule.ids>314,777,781,3537,27905,27906,45976</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&amp;idt=24594884$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21890303$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Herlambang, Bagus, MD</creatorcontrib><creatorcontrib>Orihashi, Kazumasa, MD, PhD</creatorcontrib><creatorcontrib>Mizukami, Taketomo, MD, PhD</creatorcontrib><creatorcontrib>Takahashi, Shinya, MD, PhD</creatorcontrib><creatorcontrib>Uchida, Naomichi, MD, PhD</creatorcontrib><creatorcontrib>Hiyama, Eiso, MD, PhD</creatorcontrib><creatorcontrib>Sueda, Taijiro, MD, PhD</creatorcontrib><title>New method for absolute spinal cord ischemia protection in rabbits</title><title>Journal of vascular surgery</title><addtitle>J Vasc Surg</addtitle><description>Objective This study aims to establish a superior procedure to prevent spinal cord damage after severe spinal cord ischemia during aortic surgery. We examined the synergistic effect of topical hypothermia of the spinal cord combined with radical scavenger infusion into the clamped segment of the aorta to prevent spinal cord damage in an animal model. Methods Spinal cord ischemia was induced in rabbits by clamping the aorta between the renal artery and aortic bifurcation for 30 minutes. Rabbits were divided into four groups of 16 each: group I, sham-operated; group II, edaravone (6 mL, 4°C, 1 mg/kg); group III, saline (6 mL, 4°C) with transvertebral cooling pads; group IV, edaravone (6 mL, 4°C, 1 mg/kg) and transvertebral cooling pads. Solutions were injected into the clamped segment of the aorta. Postoperative assessments included the Tarlov score, spinal cord histopathology, and measurement of malondialdehyde levels in the spinal cord tissue. Results At 48 hours after reperfusion, the mean Tarlov scores in groups I, II, III, and IV were 4.0, 1.5, 1.9, and 4.0, respectively. The mean number of normal motor neurons was significantly higher in groups I (54.1) and IV (53.7) than in groups II (32.8) and III (36.3; P &lt; .001). The mean malondialdehyde level in groups I (19.8 nmol/mL) and IV (22.6 nmol/mL) was significantly lower than in groups II (64.8 nmol/mL) and III (60.9 nmol/mL; P &lt; .001). At 168 hours after reperfusion, the mean Tarlov scores in groups I, II, III, and IV were 4.0, 1.1, 1.3, and 4.0, respectively. The mean number of normal motor neurons was significantly higher in groups I (52.9) and IV (50.8) than in groups II (22.4) and III (25.9; P &lt; .001). The mean malondialdehyde level in groups I (20.7 nmol/mL) and IV (23.4 nmol/mL) was significantly lower than in groups II (68.9 nmol/mL) and III (61.6 nmol/mL; P &lt; .001). Conclusion In a rabbit model with aortic clamping up to 30 minutes, which consistently produces complete paraplegia in rabbits, spinal cord damage was partially reduced by topical cooling with transvertebral cooling pads or the injection of edaravone into the clamped segment of aorta, but was more effectively protected by a combined use of these two strategies.</description><subject>Animals</subject><subject>Antipyrine - administration &amp; dosage</subject><subject>Antipyrine - analogs &amp; derivatives</subject><subject>Aorta - surgery</subject><subject>Biological and medical sciences</subject><subject>Biomarkers - metabolism</subject><subject>Blood and lymphatic vessels</subject><subject>Cardiology. Vascular system</subject><subject>Combined Modality Therapy</subject><subject>Constriction</subject><subject>Disease Models, Animal</subject><subject>Diseases of the aorta</subject><subject>Free Radical Scavengers - administration &amp; dosage</subject><subject>Hypothermia, Induced</subject><subject>Infusions, Intra-Arterial</subject><subject>Malondialdehyde - metabolism</subject><subject>Medical sciences</subject><subject>Motor Neurons - drug effects</subject><subject>Motor Neurons - pathology</subject><subject>Neurologic Examination</subject><subject>Neuroprotective Agents - administration &amp; dosage</subject><subject>Oxidative Stress - drug effects</subject><subject>Paraplegia - prevention &amp; control</subject><subject>Rabbits</subject><subject>Reperfusion Injury - metabolism</subject><subject>Reperfusion Injury - pathology</subject><subject>Reperfusion Injury - physiopathology</subject><subject>Reperfusion Injury - prevention &amp; control</subject><subject>Severity of Illness Index</subject><subject>Spinal Cord Ischemia - metabolism</subject><subject>Spinal Cord Ischemia - pathology</subject><subject>Spinal Cord Ischemia - physiopathology</subject><subject>Spinal Cord Ischemia - prevention &amp; control</subject><subject>Surgery</subject><subject>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</subject><subject>Time Factors</subject><subject>Vascular surgery: aorta, extremities, vena cava. Surgery of the lymphatic vessels</subject><subject>Vascular Surgical Procedures - adverse effects</subject><issn>0741-5214</issn><issn>1097-6809</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kU9v1DAQxS0EotvCB-CCfEGcsoz_xHaEhAQVhUpVOQBny3EmqkMSL3ZS1G-Pl11A6qHSSHP5vZmn9wh5wWDLgKk3w3a4zVsOjG1BlhGPyIZBoytloHlMNqAlq2rO5Ak5zXmAAtZGPyUnnJkGBIgN-XCNv-iEy03saB8TdW2O47ogzbswu5H6mDoasr_BKTi6S3FBv4Q40zDT5No2LPkZedK7MePz4z4j3y8-fjv_XF19-XR5_v6q8rVUS6Vk69FpUNobw1BpFK5TCkTrQHondat7yX3dci48Z53vORqnsXZeIEgjzsjrw93i4ueKebFTMYbj6GaMa7amUTVvmJGFZAfSp5hzwt7uUphcurMM7D45O9iSnN0nZ0GWEUXz8nh9bSfs_in-RlWAV0fAZe_GPrnZh_yfk3UjzZ_nbw8clixuAyabfcDZYxdSyc52MTxo4909tR_DHMrDH3iHeYhrKrVky2zmFuzXfcX7hhkDaOpait-v56At</recordid><startdate>20111001</startdate><enddate>20111001</enddate><creator>Herlambang, Bagus, MD</creator><creator>Orihashi, Kazumasa, MD, PhD</creator><creator>Mizukami, Taketomo, MD, PhD</creator><creator>Takahashi, Shinya, MD, PhD</creator><creator>Uchida, Naomichi, MD, PhD</creator><creator>Hiyama, Eiso, MD, PhD</creator><creator>Sueda, Taijiro, MD, PhD</creator><general>Mosby, Inc</general><general>Elsevier</general><scope>6I.</scope><scope>AAFTH</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20111001</creationdate><title>New method for absolute spinal cord ischemia protection in rabbits</title><author>Herlambang, Bagus, MD ; Orihashi, Kazumasa, MD, PhD ; Mizukami, Taketomo, MD, PhD ; Takahashi, Shinya, MD, PhD ; Uchida, Naomichi, MD, PhD ; Hiyama, Eiso, MD, PhD ; Sueda, Taijiro, MD, PhD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c546t-64bcea7067c881e67e3ad6603ba04ca47b7f42c5b223c21dcf2e8a7e5ac3e0483</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><topic>Animals</topic><topic>Antipyrine - administration &amp; dosage</topic><topic>Antipyrine - analogs &amp; derivatives</topic><topic>Aorta - surgery</topic><topic>Biological and medical sciences</topic><topic>Biomarkers - metabolism</topic><topic>Blood and lymphatic vessels</topic><topic>Cardiology. Vascular system</topic><topic>Combined Modality Therapy</topic><topic>Constriction</topic><topic>Disease Models, Animal</topic><topic>Diseases of the aorta</topic><topic>Free Radical Scavengers - administration &amp; dosage</topic><topic>Hypothermia, Induced</topic><topic>Infusions, Intra-Arterial</topic><topic>Malondialdehyde - metabolism</topic><topic>Medical sciences</topic><topic>Motor Neurons - drug effects</topic><topic>Motor Neurons - pathology</topic><topic>Neurologic Examination</topic><topic>Neuroprotective Agents - administration &amp; dosage</topic><topic>Oxidative Stress - drug effects</topic><topic>Paraplegia - prevention &amp; control</topic><topic>Rabbits</topic><topic>Reperfusion Injury - metabolism</topic><topic>Reperfusion Injury - pathology</topic><topic>Reperfusion Injury - physiopathology</topic><topic>Reperfusion Injury - prevention &amp; control</topic><topic>Severity of Illness Index</topic><topic>Spinal Cord Ischemia - metabolism</topic><topic>Spinal Cord Ischemia - pathology</topic><topic>Spinal Cord Ischemia - physiopathology</topic><topic>Spinal Cord Ischemia - prevention &amp; control</topic><topic>Surgery</topic><topic>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</topic><topic>Time Factors</topic><topic>Vascular surgery: aorta, extremities, vena cava. Surgery of the lymphatic vessels</topic><topic>Vascular Surgical Procedures - adverse effects</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Herlambang, Bagus, MD</creatorcontrib><creatorcontrib>Orihashi, Kazumasa, MD, PhD</creatorcontrib><creatorcontrib>Mizukami, Taketomo, MD, PhD</creatorcontrib><creatorcontrib>Takahashi, Shinya, MD, PhD</creatorcontrib><creatorcontrib>Uchida, Naomichi, MD, PhD</creatorcontrib><creatorcontrib>Hiyama, Eiso, MD, PhD</creatorcontrib><creatorcontrib>Sueda, Taijiro, MD, PhD</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of vascular surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Herlambang, Bagus, MD</au><au>Orihashi, Kazumasa, MD, PhD</au><au>Mizukami, Taketomo, MD, PhD</au><au>Takahashi, Shinya, MD, PhD</au><au>Uchida, Naomichi, MD, PhD</au><au>Hiyama, Eiso, MD, PhD</au><au>Sueda, Taijiro, MD, PhD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>New method for absolute spinal cord ischemia protection in rabbits</atitle><jtitle>Journal of vascular surgery</jtitle><addtitle>J Vasc Surg</addtitle><date>2011-10-01</date><risdate>2011</risdate><volume>54</volume><issue>4</issue><spage>1109</spage><epage>1116</epage><pages>1109-1116</pages><issn>0741-5214</issn><eissn>1097-6809</eissn><coden>JVSUES</coden><abstract>Objective This study aims to establish a superior procedure to prevent spinal cord damage after severe spinal cord ischemia during aortic surgery. We examined the synergistic effect of topical hypothermia of the spinal cord combined with radical scavenger infusion into the clamped segment of the aorta to prevent spinal cord damage in an animal model. Methods Spinal cord ischemia was induced in rabbits by clamping the aorta between the renal artery and aortic bifurcation for 30 minutes. Rabbits were divided into four groups of 16 each: group I, sham-operated; group II, edaravone (6 mL, 4°C, 1 mg/kg); group III, saline (6 mL, 4°C) with transvertebral cooling pads; group IV, edaravone (6 mL, 4°C, 1 mg/kg) and transvertebral cooling pads. Solutions were injected into the clamped segment of the aorta. Postoperative assessments included the Tarlov score, spinal cord histopathology, and measurement of malondialdehyde levels in the spinal cord tissue. Results At 48 hours after reperfusion, the mean Tarlov scores in groups I, II, III, and IV were 4.0, 1.5, 1.9, and 4.0, respectively. The mean number of normal motor neurons was significantly higher in groups I (54.1) and IV (53.7) than in groups II (32.8) and III (36.3; P &lt; .001). The mean malondialdehyde level in groups I (19.8 nmol/mL) and IV (22.6 nmol/mL) was significantly lower than in groups II (64.8 nmol/mL) and III (60.9 nmol/mL; P &lt; .001). At 168 hours after reperfusion, the mean Tarlov scores in groups I, II, III, and IV were 4.0, 1.1, 1.3, and 4.0, respectively. The mean number of normal motor neurons was significantly higher in groups I (52.9) and IV (50.8) than in groups II (22.4) and III (25.9; P &lt; .001). The mean malondialdehyde level in groups I (20.7 nmol/mL) and IV (23.4 nmol/mL) was significantly lower than in groups II (68.9 nmol/mL) and III (61.6 nmol/mL; P &lt; .001). Conclusion In a rabbit model with aortic clamping up to 30 minutes, which consistently produces complete paraplegia in rabbits, spinal cord damage was partially reduced by topical cooling with transvertebral cooling pads or the injection of edaravone into the clamped segment of aorta, but was more effectively protected by a combined use of these two strategies.</abstract><cop>New York, NY</cop><pub>Mosby, Inc</pub><pmid>21890303</pmid><doi>10.1016/j.jvs.2011.04.043</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record>
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subjects Animals
Antipyrine - administration & dosage
Antipyrine - analogs & derivatives
Aorta - surgery
Biological and medical sciences
Biomarkers - metabolism
Blood and lymphatic vessels
Cardiology. Vascular system
Combined Modality Therapy
Constriction
Disease Models, Animal
Diseases of the aorta
Free Radical Scavengers - administration & dosage
Hypothermia, Induced
Infusions, Intra-Arterial
Malondialdehyde - metabolism
Medical sciences
Motor Neurons - drug effects
Motor Neurons - pathology
Neurologic Examination
Neuroprotective Agents - administration & dosage
Oxidative Stress - drug effects
Paraplegia - prevention & control
Rabbits
Reperfusion Injury - metabolism
Reperfusion Injury - pathology
Reperfusion Injury - physiopathology
Reperfusion Injury - prevention & control
Severity of Illness Index
Spinal Cord Ischemia - metabolism
Spinal Cord Ischemia - pathology
Spinal Cord Ischemia - physiopathology
Spinal Cord Ischemia - prevention & control
Surgery
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Time Factors
Vascular surgery: aorta, extremities, vena cava. Surgery of the lymphatic vessels
Vascular Surgical Procedures - adverse effects
title New method for absolute spinal cord ischemia protection in rabbits
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