Document Detail


Continuous monitoring of middle cerebral artery recanalization with transcranial color-coded sonography and Levovist.
MedLine Citation:
PMID:  15976968     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND PURPOSE: Treatment of acute ischemic stroke with intravenous recombinant tissue plasminogen activator (rtPA) is relatively ineffective in patients with large vessel occlusion. Numerous experimental studies have demonstrated that ultrasound (US) can accelerate enzymatic fibrinolysis and acceleration of lysis by US is enhanced in the presence of microbubbles used as echo-contrast agents. The purpose of this study was to evaluate the feasibility of continuous monitoring of middle cerebral artery (MCA) recanalization using transcranial color-coded sonography (TCCS) and intravenously administered microbubbles. METHODS: Recanalization of middle cerebral artery (MCA) mainstem occlusion was assessed using continuous monitoring with TCCS and intravenously administered galactose-based microbubbles (Levovist) in 8 consecutive patients with acute ischemic stroke treated with intravenous rt-PA within 3 hours of symptom onset. RESULTS: Recanalization at one hour occurred in 4 of 8 patients. The median NIHSS score was 21 (range 10 to 28) at baseline, 15 (range 0 to 24) at 1 h, and 11 (range 0 to 22) at 24 h. Asymptomatic hemorrhagic transformation (HT) was demonstrated on brain imaging in 6 patients. CONCLUSION: This study demonstrates the feasibility of continuous monitoring of MCA recanalization using TCCS and Levovist, in acute stroke patients. The findings suggest a high rate of asymptomatic HT in monitored patients. Although all HTs were asymptomatic and did not preclude early clinical improvement, particular attention should be given to the incidence and clinical significance of HT in future studies using these methods.
Authors:
Alain Viguier; Raphael Petit; Mathieu Rigal; Pascal Cintas; Vincent Larrue
Related Documents :
12766368 - The role of blood pressure in lacunar strokes preceded by tias.
20714158 - Symptomatic hemorrhagic transformation and its predictors in acute ischemic stroke with...
2472468 - An investigation of factors affecting progress of patients on a stroke unit.
8584128 - Transesophageal echocardiography in patients less than 60 years of age without obvious ...
19840378 - Gastroesophageal reflux in mechanically ventilated pediatric patients and its relation ...
8772928 - Sydenham's chorea.
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of thrombosis and thrombolysis     Volume:  19     ISSN:  0929-5305     ISO Abbreviation:  J. Thromb. Thrombolysis     Publication Date:  2005 Feb 
Date Detail:
Created Date:  2005-06-24     Completed Date:  2005-09-21     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9502018     Medline TA:  J Thromb Thrombolysis     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  55-9     Citation Subset:  IM    
Affiliation:
Department of Neurology, University of Toulouse, Hôpital de Rangueil, 1 Avenue Jean-Poulhes, EA 2049 Toulouse Cedex 9, France. viguier.a@chu-toulouse.fr
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Angioplasty, Balloon
Cerebral Arterial Diseases / drug therapy,  therapy*,  ultrasonography*
Contrast Media
Fibrinolytic Agents / administration & dosage,  therapeutic use
Humans
Infusions, Intravenous
Middle Cerebral Artery / ultrasonography*
Monitoring, Physiologic / methods
Polysaccharides* / administration & dosage
Recombinant Proteins / administration & dosage,  therapeutic use
Retrospective Studies
Tissue Plasminogen Activator / administration & dosage,  therapeutic use
Ultrasonography, Doppler, Color
Ultrasonography, Doppler, Transcranial*
Chemical
Reg. No./Substance:
0/Contrast Media; 0/Fibrinolytic Agents; 0/Polysaccharides; 0/Recombinant Proteins; 127279-08-7/SHU 508; EC 3.4.21.68/Tissue Plasminogen Activator

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


Previous Document:  Impact of platelet glycoprotein IIb/IIIa inhibitor therapy on in-hospital outcomes and long-term sur...
Next Document:  Is tissue-plasminogen activator gene polymorphism a risk factor for venous thromboembolism in every ...