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Microbubble potentiated transcranial duplex ultrasound enhances IV thrombolysis in acute stroke

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Abstract

Background

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.

Methods

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).

Results

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).

Conclusions

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.

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Authors and Affiliations

  1. Department of Neurology, Neurosonology Unit, HUG, University Hospital and Medical School of Geneva, Micheli-du-Crest 24, 1211, Geneva 14, Switzerland

    Fabienne Perren, Jaouad Loulidi, Davide Poglia, Theodor Landis & Roman Sztajzel

Authors
  1. Fabienne Perren
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  2. Jaouad Loulidi
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  3. Davide Poglia
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  4. Theodor Landis
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  5. Roman Sztajzel
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Correspondence to Fabienne Perren.

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Perren, F., Loulidi, J., Poglia, D. et al. Microbubble potentiated transcranial duplex ultrasound enhances IV thrombolysis in acute stroke. J Thromb Thrombolysis 25, 219–223 (2008). https://doi.org/10.1007/s11239-007-0044-6

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  • DOI: https://doi.org/10.1007/s11239-007-0044-6

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