Handbook on Neurovascular Ultrasound, Therapeutic transcranial doppler sonography

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

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

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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

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

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Anotace

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.