Ultrasound-assisted thrombolysis for stroke therapy: better thrombus break-up with bubbles.
Ultrasound-assisted thrombolysis for stroke therapy: better thrombus break-up with bubbles.
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DOI：
10.1161/strokeaha.110.595348
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发表时间：
2010-10
期刊：
影响因子：
8.3
通讯作者：
Holland CK
中科院分区：
文献类型：
--
作者：
Hitchcock KE;Holland CK
超声已被证明通过稳定的空化或持续的气泡活性增加rt-PA溶栓，但该机制需要进一步优化。使用低频超声结合微泡稳定的溶解，在超声造影剂的形式，导致更大的溶解效果在体外。本文综述了超声增强溶栓的发展动机，以及其作为缺血性卒中干预的潜力的现有证据。稳定的空化进行了讨论，目前在体外和离体研究的气泡介导的rt-PA凝块溶解进行了总结。超声驱动的稳定空化通过回波造影剂的输注而成核，促进rt-PA溶栓。优化这种轻微的缺血现象有可能降低缺血性卒中患者的发病率和死亡率。
Ultrasound has been shown to increase rt-PA thrombolysis via stable cavitation, or sustained bubble activity, but this mechanism needs further optimization. Use of low-frequency ultrasound in combination with microbubbles stabilized against dissolution, in the form of ultrasound contrast agents, has resulted in greater lytic efficacy in vitro. This article reviews the motivation for developing ultrasound-enhanced thrombolysis, and the existing evidence for its potential as an intervention for ischemic stroke. Stable cavitation is discussed and current in vitro and ex vivo studies of bubble-mediated rt-PA clot lysis are summarized. Ultrasound-driven stable cavitation nucleated by an infusion of an echo contrast agent facilitates rt-PA thrombolysis. Optimization of this gently effervescent phenomenon has the potential to reduce the morbidity and mortality of victims of ischemic stroke.