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Quantification of Target Population for Ultrasound Enhanced Thrombolysis in Acute Ischemic Stroke.
MedLine Citation:
PMID:  21848678     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND AND PURPOSE: Insonation of the occluded target vessel (sonothrombolysis) has been reported to increase the effect of intravenous thrombolysis in ischemic stroke. Its use has predominantly been described in middle cerebral artery (MCA) occlusions. Sufficient insonation conditions are a mandatory precondition. The impact of these limitations on eligibility rates for sonothrombolysis has not been reported so far. METHODS: Consecutive patients treated with rt-PA and examined by either CT- or MR-angiogram before treatment and by transcranial color-coded duplex sonography (TCCS) during inhospital stay were identified retrospectively at three hospitals from ongoing data registries. RESULTS: One-hundred and seventy-nine patients (age [years], median [IQR]= 75 [65-83]; 42% female; NIH Stroke Scale [NIHSS], median [IQR]= 10 [6-17]) were analyzed. MCA occlusions were detected in 39% of patients (N= 69) with 48 (27%) occlusions in the proximal M1-segment and 21 (12%) in a distal M2-segment. Arterial occlusions others than MCA were seen in an additional 9% (N= 16). TCCS (without contrast agent) revealed sufficient bone windows in 70% of patients with MCA occlusions (N= 48) corresponding to 27% of all patients treated with thrombolysis. CONCLUSION: Conventional sonothrombolysis is restricted to a minority of stroke patients suitable for intravenous thrombolysis. Extending the applicability by utilization of ultrasound contrast agents and targeting non-MCA-occlusions warrants further evaluation.
Authors:
Christian H Nolte; Florian Doepp; Stephan J Schreiber; Lea M Gerischer; Heinrich J Audebert
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-8-17
Journal Detail:
Title:  Journal of neuroimaging : official journal of the American Society of Neuroimaging     Volume:  -     ISSN:  1552-6569     ISO Abbreviation:  -     Publication Date:  2011 Aug 
Date Detail:
Created Date:  2011-8-18     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9102705     Medline TA:  J Neuroimaging     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2011 by the American Society of Neuroimaging.
Affiliation:
From the Department of Neurology, Centre for Stroke Research Berlin Charite, Campus Benjamin Franklin Hindenburgdamm 30 12200, Berlin, Germany (CHN, LMG, HJA); Department of Neurology, Charite Campus Virchow Klinikum Augustenburger Platz 1 13353, Berlin, Germany (FD); Department of Neurology, Charite Campus Mitte, Chariteplatz 1 10117, Berlin, Germany (SJS).
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