Patients having diminished circulation in the cerebral vasculature as a result of
stroke or from other causes such as cardiac arrest, shock or
head trauma, or
aneurysm surgery or aortic
surgery, are treated by flowing an oxygenated medium through an arterial
access site into the cerebral vasculature and collecting the medium through an
access site in the venous site of the cerebral vasculature. Usually, the cold oxygenated medium will comprise
autologous blood, and the blood will be recirculated for a time sufficient to permit treatment of the underlying cause of diminished circulation. In addition to
oxygenation, the recirculating blood will also be cooled to hypothermically treat and preserve
brain tissue. Isolation and cooling of cerebral vasculature in patients undergoing aortic and other procedures is achieved by internally occluding at least the right
common carotid artery above the
aortic arch. Blood or other oxygenated medium is perfused through the occluded
common carotid artery(ies) and into the arterial cerebral vasculature. Usually,
oxygen depleted blood or other medium leaving the cerebral vasculature is collected, oxygenated, and cooled in an
extracorporeal circuit so that it may be returned to the patient.
Occlusion of the carotid
artery(ies) is preferably accomplished using expansible occluders, such as
balloon-tipped cannula, catheters, or similar access devices. Access to the
occlusion site(s) may be open surgical,
percutaneous, or intravascular.