Ultrasound accelerates thrombolysis of acutely induced platelet-rich thrombi similar to those in acute myocardial infarction
Ultrasound accelerates thrombolysis of acutely induced platelet-rich thrombi similar to those in acute myocardial infarction
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DOI：
10.1253/circj.71.1643
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发表时间：
2007-10-01
影响因子：
3.3
通讯作者：
Saito, Yoshihiko
中科院分区：
文献类型：
--
作者：
Kawata, Hiroyuki;Naya, Noriyuki;Saito, Yoshihiko
背景 尽管声波溶栓已被研究用于比目前使用的方法更安全、更有效的再通发展，但尚未研究声波溶栓对通常引起急性心肌梗死 (AMI) 的富含血小板的血栓的功效。在兔股动脉闭塞模型中，研究了超声波（US）对药物溶解富血小板血栓的作用。方法和结果在35只兔子中，每隔4周反复对右股动脉进行球囊损伤，以诱导富血小板血栓。诱导闭塞血栓后两小时，通过耳静脉注射 27,500IU/kg 组织纤溶酶原激活剂 (tPA)，有或没有经皮超声（连续波，1 MHz，0.75 W/cm(2)），或与超声一起施用 13,750IU/kg tPA（n=10）。无论使用的 tPA 剂量如何，使用 US 的溶栓成功率（心肌梗死 3 级溶栓）（90.0%）均显着高于未使用 US 的溶栓率（10.0%）（p < 0.01）。超声检查后受影响股动脉的峰值流速显着升高（p < 0.01），组织学检查证实血栓完全溶解。然而，血栓并不受单独超声的影响（n=5）。结论超声促进富含血小板的血栓的溶栓，并且可能是AMI后溶栓治疗的有用组成部分。
Background Although sonothrombolysis has been studied for development of recanalization that is safer and more efficacious than the methods currently used, there have been no studies of the efficacy of sonothrombolysis for the platelet-rich thrombi that typically cause acute myocardial infarction (AMI). The effects of adding ultrasound (US) to pharmacological lysis of platelet-rich thrombi was examined in a rabbit model of femoral artery occlusion.Methods and Results In 35 rabbits, the right femoral artery was balloon-injured repeatedly at 4-week intervals to induce platelet-rich thrombi. Two hours after the induction of occlusive thrombi, 27,500IU/kg tissue plasminogen activator (tPA) were injected via an ear vein, with or without transcutaneous US (continuous wave, 1 MHz, 0.75 W/cm(2)), or 13,750IU/kg tPA was administered with US (n=10). Significantly higher rates of successful thrombolysis (Thrornbolysis In Myocardial Infarction grade 3) were observed with US (90.0%) than without it (10.0%), irrespective of the dose of tPA used (p < 0.01). The peak flow velocity in affected femoral arteries was significantly higher with US (p < 0.01), and histological examination confirmed complete dissolution of thrombi. However, the thrombi were not affected by US alone (n=5).Conclusions US facilitates thrombolysis of platelet-rich thrombi and could be a useful component of thrombolytic therapy following AMI.