Handbook on Neurovascular Ultrasound, Therapeutic transcranial
doppler sonography

B 2006

Handbook on Neurovascular Ultrasound, Therapeutic transcranial doppler sonography

MIKULÍK, Robert and Andrei ALEXANDROV

Basic information

Original name

Handbook on Neurovascular Ultrasound, Therapeutic transcranial doppler sonography

Name in Czech

Terapeutické aplikace transkraniálního ultrazvuku

Authors

MIKULÍK, Robert (203 Czech Republic, guarantor) and Andrei ALEXANDROV (840 United States of America)

Edition

Switzeraland,Basel, 11 pp. Front Neurol Neurosci, 2006

Publisher

Karger

Other information

Language

English

Type of outcome

Odborná kniha

Field of Study

30000 3. Medical and Health Sciences

Country of publisher

Switzerland

Confidentiality degree

není předmětem státního či obchodního tajemství

References:

URL

Organization unit

Faculty of Medicine

ISBN

3-8055-8022-3

Keywords (in Czech)

CMP;transkraniální uultrazvuk;terapie

Keywords in English

stroke;transcranial ultrasound;therapy

Abstract

ORIG CZ

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.

In Czech

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.

Detailed Information on Publication Record