Effective and safe conditions of low-frequency transcranial ultrasonic thrombolysis for acute ischemic stroke - Neurologic and histologic evaluation in a rat middle cerebral artery stroke model
Effective and safe conditions of low-frequency transcranial ultrasonic thrombolysis for acute ischemic stroke - Neurologic and histologic evaluation in a rat middle cerebral artery stroke model
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DOI：
10.1161/strokeaha.107.496117
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发表时间：
2008-03-01
期刊：
影响因子：
8.3
通讯作者：
Furuhata, Hiroshi
中科院分区：
文献类型：
--
作者：
Saguchi, Takayuki;Onoue, Hisashi;Furuhata, Hiroshi
背景和目的-经颅超声（TUS）可促进血栓溶解，有望用于治疗缺血性卒中。然而，其在改善神经功能方面的有效性及其在活组织中的安全性尚未完全确定。我们研究的有效性和安全性的低频率TUS在适当的条件下，超声溶栓治疗大鼠大脑中动脉中风model.Methods -六十五只雄性Wistar大鼠。随机选择右侧大脑中动脉卒中并表现出左侧轻偏瘫的大鼠，并随机分为3组：（1）对照组，无治疗;（2）tPA组，大脑中动脉卒中后3小时静脉注射组织型纤溶酶原激活剂;或（3）TUS、tPA给药和TUS应用（490 kHz，连续波，强度为0.8 W/cm（2））。中风发作后24小时，评估神经功能改善，然后取出大脑。检查右侧大脑中动脉起点处的血栓溶解。比较3组的溶栓率、脑梗死率和出血的组织学证据率。（P = 0.008），溶栓率较高（P = 0.041），脑梗死体积减少（P = 0.047），结论：我们的研究结果表明，溶栓治疗低，在适当的条件下进行高频TUS是治疗缺血性脑卒中的一种安全有效的方法。
Background and Purpose - Transcranial ultrasound (TUS) enhances thrombolysis and is expected to be useful for the treatment of ischemic stroke. However, neither its effectiveness in improving neurologic outcome nor its safety in living tissue has been fully established. We examined the efficacy and safety of low-frequency TUS under appropriate conditions of ultrasound for thrombolytic treatment in a rat middle cerebral artery stroke model.Methods - Sixty-five male Wistar rats were used. Rats with right middle cerebral artery stroke exhibiting left hemiparesis were blindly selected and randomly assigned to 1 of 3 groups: (1) control, no therapy; (2) tPA, intravenous administration of tissue plasminogen activator 3 hours after middle cerebral artery stroke, or (3) TUS, tPA administration and application of TUS (490 kHz, continuous wave, at an intensity of 0.8 W/cm(2)). Twenty-four hours after the onset of stroke, neurologic improvement was evaluated and brains were then removed. Thrombolysis at the origin of the right middle cerebral artery was examined. Thrombolysis ratio, cerebral infarct ratio, and rate of histologic evidence of hemorrhage were compared in the 3 groups.Results - Significantly better neurologic improvement (P = 0.008), a higher thrombolysis ratio (P = 0.041), and a reduction of cerebral infarct volume (P = 0.047) were obtained in the TUS group compared with the tPA group, without an increase in hemorrhagic transformation.Conclusions - Our findings suggest that thrombolytic treatment with low-frequency TUS under appropriate conditions could be an effective and safe method of treatment for ischemic stroke.