Microbubble potentiated transcranial duplex ultrasound enhances IV thrombolysis in acute stroke
- 291 Downloads
We studied whether 2 MHz transcranial color-coded duplex ultrasound (TCCD), combined with a second generation ECA, accelerate IV rtPA-thrombolysis in the acute phase of MCA stroke more than TCCD monitoring alone.
Non-randomized acute MCA stroke patients undergoing IV rtPA-thrombolysis and 2 MHZ-TCCD monitoring over 60 min, with (N = 11) or without (N = 15) additional continuous ECA (5 ml, SonoVue®) perfusion, were compared. Recanalization of the MCA was measured pre- and post-thrombolysis with the thrombolysis in brain ischemia (TIBI) grading system, clinical outcome was assessed at admission and 24 h after treatment using the NIH stroke scale (NIHSS).
Patients who received ECA improved their NIHSS significantly more than those who were only TCCD monitored (Mann–Whitney U = 48.0; P = 0.050), and their flow signal improved more (Mann–Whitney U = 40.0; P < 0.03).
The results of this pilot study show that in IV-thrombolysis the use of ECA in addition to TCCD monitoring lead to a greater immediate clinical improvement and to a better flow signal.
KeywordsStroke Thrombolysis Transcranial ultrasound Microbubbles
- 6.Molina CA, Ribo M, Rubiera M, Montaner J, Santamarina E, Delgado-Mederos R et al (2006) Microbubble administration accelerates clot lysis during continuous 2-MHz ultrasound monitoring in stroke patients treated with intravenous tissue plasminogen activator. Stroke 37:425–429PubMedCrossRefGoogle Scholar
- 12.Alexandrov AV, Molina CA, Grotta JC, Garami Z, Ford SR, Alvarez-Sabin J et al for the CLOTBUST investigators (2004) Ultrasound-enhanced thrombolysis for acute ischemic stroke. N Engl J Med 351:2170–2178Google Scholar
- 22.Von Kummer R, Holle R, Rosin L, Forsting M, Hacke W (1995) Does arterial recanalization improve outcome in carotid territory stroke? Stroke 26:581–587Google Scholar