Handbook on Neurovascular Ultrasound, Therapeutic transcranial doppler sonography

MIKULÍK, Robert a Andrei ALEXANDROV. Handbook on Neurovascular Ultrasound, Therapeutic transcranial doppler sonography. Switzeraland,Basel: Karger. 11 s. Front Neurol Neurosci. ISBN 3-8055-8022-3. 2006.

Základní údaje

• Originální název: Handbook on Neurovascular Ultrasound, Therapeutic transcranial doppler sonography
• Název česky: Terapeutické aplikace transkraniálního ultrazvuku
• Autoři: MIKULÍK, Robert (203 Česká republika, garant) a Andrei ALEXANDROV (840 Spojené státy).
• Vydání: Switzeraland,Basel, 11 s. Front Neurol Neurosci, 2006.
• Nakladatel: Karger

Další údaje

• Originální jazyk: angličtina
• Typ výsledku: Odborná kniha
• Obor: 30000 3. Medical and Health Sciences
• Stát vydavatele: Švýcarsko
• Utajení: není předmětem státního či obchodního tajemství
• WWW: URL
• Organizační jednotka: Lékařská fakulta
• ISBN: 3-8055-8022-3
• Klíčová slova česky: CMP;transkraniální uultrazvuk;terapie
• Klíčová slova anglicky: stroke;transcranial ultrasound;therapy
• Štítky: Stroke, THERAPY, transcranial ultrasound
• Příznaky: Mezinárodní význam, Recenzováno

Anotace

Ultrasound (US) has emerged as a new tool to treat ischemic stroke. The potential advantage of US is decreased risk of systemic bleeding complications due to its site-specific effect. Moreover, external application is noninvasive and is readily available. Experimental studies showed that low intensity (equal or less than 2 W/cm2) US safely enhanced thrombolytic drug activity within a wide range of frequencies (0.04--3.4 MHz). In humans, transcranial sonothrombolysis with mid-kiloHertz frequencies showed an unacceptably high rate of intracranial bleeding, while the use of 2 MHz yielded promising results in The Combined Lysis of Thrombus in Brain Ischemia Using Transcranial Ultrasound and Systemic TPA (CLOTBUST) study. This study was a phase II randomized clinical trial that included patients with middle cerebral artery (MCA) occlusion within 3 h of stroke onset, who were treated with standard dose of tissue plasminogen activator (t-PA). Residual flow in MCA was monitored with 2 MHz US in one group, and the rate of complete recanalization and dramatic clinical recovery significantly increased as compared to t-PA alone. This chapter further discusses diagnosis of an acute occlusion and recanalization using the thrombolysis in brain ischemia (TIBI) waveform flow grading scale, application of fast track insonation protocol, and administration of US. Also, the potential enhancement of sonothrombolysis with microbubbles is discussed.

Anotace česky

Ultrasound (US) has emerged as a new tool to treat ischemic stroke. The potential advantage of US is decreased risk of systemic bleeding complications due to its site-specific effect. Moreover, external application is noninvasive and is readily available. Experimental studies showed that low intensity (equal or less than2 W/cm2) US safely enhanced thrombolytic drug activity within a wide range of frequencies (0.04--3.4 MHz). In humans, transcranial sonothrombolysis with mid-kiloHertz frequencies showed an unacceptably high rate of intracranial bleeding, while the use of 2 MHz yielded promising results in The Combined Lysis of Thrombus in Brain Ischemia Using Transcranial Ultrasound and Systemic TPA (CLOTBUST) study. This study was a phase II randomized clinical trial that included patients with middle cerebral artery (MCA) occlusion within 3 h of stroke onset, who were treated with standard dose of tissue plasminogen activator (t-PA). Residual flow in MCA was monitored with 2 MHz US in one group, and the rate of complete recanalization and dramatic clinical recovery significantly increased as compared to t-PA alone. This chapter further discusses diagnosis of an acute occlusion and recanalization using the thrombolysis in brain ischemia (TIBI) waveform flow grading scale, application of fast track insonation protocol, and administration of US. Also, the potential enhancement of sonothrombolysis with microbubbles is discussed.