2006
Handbook on Neurovascular Ultrasound, Therapeutic transcranial doppler sonography
MIKULÍK, Robert a Andrei ALEXANDROVZákladní 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
Jazyk
angličtina
Typ výsledku
Odborná kniha
Obor
30000 3. Medical and Health Sciences
Stát vydavatele
Švýcarsko
Utajení
není předmětem státního či obchodního tajemství
Odkazy
Organizační jednotka
Lékařská fakulta
ISBN
3-8055-8022-3
Klíčová slova česky
CMP;transkraniální uultrazvuk;terapie
Klíčová slova anglicky
stroke;transcranial ultrasound;therapy
Štítky
Příznaky
Mezinárodní význam, Recenzováno
Změněno: 18. 6. 2009 12:07, prof. MUDr. Robert Mikulík, Ph.D.
V originále
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.
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.