| Microbubble-augmented ultrasound sonothrombolysis decreases intracranial hemorrhage in a rabbit model of acute ischemic stroke. | |
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MedLine Citation:
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PMID: 21343824 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVES: Increasing evidence confirms that microbubble (MB)-augmented ultrasound (US) thrombolysis enhances clot lysis with or without tissue plasminogen activator (tPA). Intracranial hemorrhage (ICH) is a major complication militating against tPA use in acute ischemic stroke. We quantified the incidence of ICH associated with tPA thrombolysis and MB + US therapy and compared infarct volumes in a rabbit model of acute ischemic stroke. MATERIALS AND METHODS: Rabbits (n = 158) received a 1.0-mm clot, angiographically injected into the internal carotid artery causing infarcts. Rabbits were randomized to 6 test groups including (1) control (n = 50), embolized without therapy, (2) US (n = 18), (3) tPA only (n = 27), (4) tPA + US (n = 22), (5) MB + US (n = 27), and (6) tPA + MB + US (n = 14). US groups received pulsed wave US (1 MHz, 0.8 W/cm) for 1 hour; rabbits with tPA received intravenous tPA (0.9 mg/kg) over 1 hour. Rabbits with MB received intravenous MB (0.16 mg/kg) given over 30 minutes. Rabbits were killed 24 hours later and infarct volume and incidence, location, and severity of ICH were determined by histology and pathologic examination. RESULTS: Percentage of rabbits having ICH outside the infarct area was significantly decreased (P = 0.004) for MB + US (19%) rabbits compared with tPA + US (73%), US only (56%), tPA (48%), tPA + MB + US (36%), and control (36%) rabbits. Incidence and severity of ICH within the infarct did not differ (P > 0.39). Infarct volume was significantly greater (P = 0.002) for rabbits receiving US (0.97% ± 0.17%) than for MB + US (0.20% ± 0.14%), tPA + US (0.15% ± 0.16%), tPA (0.14% ± 0.14%), and tPA + MB + US (0.10% ± 20%) rabbits; these treatments collectively, excluding US only, differed (P = 0.03) from control (0.45% ± 0.10%). CONCLUSIONS: Treatment with MB + US after embolization decreased the incidence of ICH and efficacy was similar to tPA in reducing infarct volume. |
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Authors:
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Rene Flores; Leah J Hennings; John D Lowery; Aliza T Brown; William C Culp |
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Publication Detail:
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Type: Journal Article; Research Support, N.I.H., Extramural |
Journal Detail:
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Title: Investigative radiology Volume: 46 ISSN: 1536-0210 ISO Abbreviation: Invest Radiol Publication Date: 2011 Jul |
Date Detail:
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Created Date: 2011-06-06 Completed Date: 2011-09-27 Revised Date: 2013-05-26 |
Medline Journal Info:
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Nlm Unique ID: 0045377 Medline TA: Invest Radiol Country: United States |
Other Details:
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Languages: eng Pagination: 419-24 Citation Subset: IM |
Affiliation:
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Department of Radiology, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Animals Cerebral Infarction / complications, therapy* Disease Models, Animal Female Fibrinolytic Agents / therapeutic use* Intracranial Hemorrhages / etiology, prevention & control* Male Microbubbles / therapeutic use* Rabbits Thrombolytic Therapy / methods* Tissue Plasminogen Activator / therapeutic use* Ultrasonic Therapy |
| Grant Support | |
ID/Acronym/Agency:
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R01 HL082481-01/HL/NHLBI NIH HHS; R01 HL092481/HL/NHLBI NIH HHS |
| Chemical | |
Reg. No./Substance:
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0/Fibrinolytic Agents; EC 3.4.21.68/Tissue Plasminogen Activator |
| Comments/Corrections | |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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