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Risk of Thromboembolic Events with Endovascular Cooling Catheters in Patients with Subarachnoid Hemorrhage

Müller, Achim ; Lorenz, Andreas ; Seifert, Burkhardt ; Keller, Emanuela

In: Neurocritical Care, 2014, vol. 21, no. 2, p. 207-210

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    Title
    • Risk of Thromboembolic Events with Endovascular Cooling Catheters in Patients with Subarachnoid Hemorrhage
    Author
    • Müller, Achim. Neurocritical Care Unit, Department of Neurosurgery, University Hospital Zurich, Frauenklinikstrasse 10, 8091, Zurich, Switzerland
    • Lorenz, Andreas. Neurocritical Care Unit, Department of Neurosurgery, University Hospital Zurich, Frauenklinikstrasse 10, 8091, Zurich, Switzerland
    • Seifert, Burkhardt. Division of Biostatistics, University of Zurich, Hirschengraben 84, 8001, Zurich, Switzerland
    • Keller, Emanuela. Neurocritical Care Unit, Department of Neurosurgery, University Hospital Zurich, Frauenklinikstrasse 10, 8091, Zurich, Switzerland
    Document Type
    • Postprint
    Language
    • English
    Published in
    • Neurocritical Care, 2014, vol. 21, no. 2, p. 207-210. Springer US; http://www.springer-ny.com
    Other Version
    OAI-PMH Identifier
    • oai:doc.rero.ch:325757
    Summary
    Introduction: Endovascular cooling is currently used for hypothermia treatment and fever reduction therapy. At the same time, little is known about the risks associated to endovascular cooling in patients treated with an endovascular cooling catheter (ECC). Methods: A retrospective chart review of 122 patients with subarachnoid hemorrhage (SAH) treated with an ECC either for therapeutic hypothermia or for fever reduction was performed. ECC-associated thromboembolic events (TEE) such as pulmonary embolism and thrombosis were recorded and compared between patients treated with an ECC and patients treated only with a central venous line (CVL). Additionally, various laboratory parameters were recorded to determine if they might be related to the frequency of TEE's. Results: 43 Patients were treated with an ECC and 79 with a CVL. Patients in the ECC group suffered more frequently from TEE (37%) than those with a CVL (5%). None of the laboratory parameters was associated with an increased TEE risk. The treatment with an ECC alone was a risk factor for a TEE, independent from age as well as from Hunt and Hess grade. Conclusion: Our data show that the treatment with ECC increases the risk of TEE in SAH patients. Therefore, especially when considered for fever reduction, non-invasive devices for surface cooling should be the first choice.