Endovascular Electrical Stimulation - A Novel Hemorrhage Control Technique.

Abstract

In this study we present a novel approach for inducing vasoconstriction by pulsed electrical treatment delivered via endovascular electrodes, which can be used in cases where external access to the vessel is limited. Using computer simulations, we optimized various geometries of endovascular electrodes to maximize the induced electric field on the arterial wall. Using the optimal configuration parameters, we investigated endovascular induced vasoconstriction in both the carotid and femoral sheep arteries. Endovascular electrodes induced robust vasoconstriction in the carotid artery of sheep, showing gradual recovery following treatment. Moreover, the obtained vasoconstriction was accompanied by a sevenfold decrease in blood loss for 100% constriction, compared with no treatment (6ml vs 42ml, p<0.001). The femoral artery was less amenable to the electrical treatment, which we hypothesize results from the reduced density of the sympathetic system's innervation of the adventitia of the sheep femoral artery, as was validated by immunohistochemical analysis. Finally, treatment safety was validated through arterial histological studies, in which no adverse effect was observed, and through computer modeling, which depicted a negligible temperature increase. These results are an important step toward developing a novel approach for inducing reversible and controlled vasoconstriction in arteries that are remote from access.