Document Detail


Can a commercial diagnostic ultrasound device accelerate thrombolysis? An in vitro skull model.
MedLine Citation:
PMID:  15591211     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND PURPOSE: Recently, 3 clinical trials revealed encouraging results in recanalization and clinical outcome in acute stroke patients when 2-MHz transcranial Doppler monitoring was applied. This study investigated whether a 1.8-MHz commercial diagnostic ultrasound device has the potential to facilitate thrombolysis using an in vitro stroke model. METHODS: Duplex-Doppler, continuous wave-Doppler, and pulsed wave (PW)-Doppler were compared on their impact on recombinant tissue plasminogen activator (rtPA)-mediated thrombolysis. Blood clots were transtemporally sonicated in a human stroke model. Furthermore, ultrasound attenuation of 5 temporal bones of different thickness was determined. RESULTS: In comparison, only PW-Doppler accelerated rtPA-mediated thrombolysis significantly. Without temporal bone, PW-Doppler plus rtPA showed a significant enhancement in relative clot weight loss of 23.7% when compared with clots treated with rtPA only (33.9+/-5.5% versus 27.4+/-5.2%; P<0.0005). Ultrasound attenuation measurements revealed decreases of the output intensity of 86.8% (8.8 dB) up to 99.2% (21.2 dB), depending on temporal bone thickness (1.91 to 5.01 mm). CONCLUSIONS: Without temporal bone, PW-Doppler significantly enhanced thrombolysis. However, because of a high attenuation of ultrasound by temporal bone, no thrombolytic effect was observed in our in vitro model, although Doppler imaging through the same temporal bone was still possible.
Authors:
Stefan Pfaffenberger; Branka Devcic-Kuhar; Christian Kollmann; Stefan P Kastl; Christoph Kaun; Walter S Speidl; Thomas W Weiss; Svitlana Demyanets; Robert Ullrich; Heinz Sochor; Christian Wöber; Josef Zeitlhofer; Kurt Huber; Martin Gröschl; Ewald Benes; Gerald Maurer; Johann Wojta; Michael Gottsauner-Wolf
Publication Detail:
Type:  Comparative Study; Evaluation Studies; In Vitro; Journal Article; Research Support, Non-U.S. Gov't     Date:  2004-12-09
Journal Detail:
Title:  Stroke; a journal of cerebral circulation     Volume:  36     ISSN:  1524-4628     ISO Abbreviation:  Stroke     Publication Date:  2005 Jan 
Date Detail:
Created Date:  2004-12-24     Completed Date:  2005-09-01     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0235266     Medline TA:  Stroke     Country:  United States    
Other Details:
Languages:  eng     Pagination:  124-8     Citation Subset:  IM    
Affiliation:
Department of Internal Medicine II, University of Vienna, Austria.
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MeSH Terms
Descriptor/Qualifier:
Blood Coagulation
Fibrinolytic Agents / pharmacology,  therapeutic use
Humans
Male
Skull / ultrasonography*
Stroke / blood,  drug therapy*,  ultrasonography
Temporal Bone / ultrasonography
Thrombolytic Therapy / instrumentation*
Tissue Plasminogen Activator / pharmacology,  therapeutic use
Ultrasonography, Doppler, Duplex
Ultrasonography, Doppler, Pulsed
Ultrasonography, Doppler, Transcranial*
Chemical
Reg. No./Substance:
0/Fibrinolytic Agents; EC 3.4.21.68/Tissue Plasminogen Activator
Comments/Corrections
Comment In:
Stroke. 2005 May;36(5):929-30; author reply 930-1   [PMID:  15867163 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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