Microbubble potentiated transcranial duplex ultrasound enhances IV thrombolysis in acute stroke

Perren, Fabienne ; Loulidi, Jaouad ; Poglia, Davide ; Landis, Theodor ; Sztajzel, Roman

In: Journal of Thrombosis and Thrombolysis, 2008, vol. 25, no. 2, p. 219-223

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    Summary
    Background: We studied whether 2MHz transcranial color-coded duplex ultrasound (TCCD), combined with a second generation ECA, accelerate IV rtPA-thrombolysis in the acute phase of MCA stroke more than TCCD monitoring alone. Methods: Non-randomized acute MCA stroke patients undergoing IV rtPA-thrombolysis and 2MHZ-TCCD monitoring over 60min, with (N=11) or without (N=15) additional continuous ECA (5ml, SonoVue®) perfusion, were compared. Recanalization of the MCA was measured pre- and post-thrombolysis with the thrombolysis in brain ischemia (TIBI) grading system, clinical outcome was assessed at admission and 24h after treatment using the NIH stroke scale (NIHSS). Results: Patients who received ECA improved their NIHSS significantly more than those who were only TCCD monitored (Mann-Whitney U=48.0; P=0.050), and their flow signal improved more (Mann-Whitney U=40.0; P<0.03). Conclusions: The results of this pilot study show that in IV-thrombolysis the use of ECA in addition to TCCD monitoring lead to a greater immediate clinical improvement and to a better flow signal