ULTRASOUND ENHANCED THROMBOLYSIS AND MONITOR

近年来的研究表明，在t-PA或尿激酶等溶栓剂存在的情况下，超声波可以促进血栓的溶解。这项建议的创新之处在于探索在活体兔股动脉人类大脑中动脉模型中的这些进展，以开发一种无创且经济有效的卒中溶栓监测和治疗方法。斯宾塞技术公司的数字多普勒技术的进步使我们能够采用一种新的双重方法来监测脑动脉再通的程度，同时利用超声波增强溶栓剂的活性。这两项活动--监测和加强治疗--都可以通过同一个经颅超声探头完成。监测活动包括使用数字多普勒彩色m型显示器轻松定位大脑循环，这种格式很容易传授给非多普勒超声专家的医疗专业人员。体外超声增强溶栓剂的性能有望减少溶栓剂对脑梗死区血流的恢复，从而降低出血性并发症的发生率。这项技术对于减少与中风相关的神经缺陷和增加实际接受溶栓治疗的合格患者的比例非常重要。拟议的商业应用：这项提议包括一个开发多普勒超声设备的平台，该设备可以监测脑血流速度，同时增强t-PA的溶栓作用。该产品将专门针对医院急救服务。经颅多普勒是在中风早期实时检测脑血流的唯一手段。目前还没有商业上可用的方式来加强超声溶栓治疗。

Research in recent years has shown that ultrasound can enhance clot lysis in the presence of thrombolytic agents such as t-PA or urokinase. The innovative aspect of this proposal is to explore these advances in an in vivo rabbit femoral artery model of the human middle cerebral artery to develop a noninvasive and cost effective method of thrombolysis monitoring and therapy in stroke. Advances in digital Doppler technology at Spencer Technologies enable a new dual approach to monitoring the degree of cerebral arterial recanalization while concurrently enhancing thrombolytic agent activity with ultrasound. Both of these activities-monitoring and therapy enhancement-can be done through the same transcranial ultrasound probe. The monitoring activity includes easy location of cerebral circulation using a digital Doppler color m-mode display, a format easily taught to medical professionals who are not Doppler ultrasound experts. Enhancing performance of thrombolytic agents with external ultrasound is anticipated to result in less thrombolytic agent required to accomplish restoration of blood flow to an infarcted region of the brain, and thereby decrease the incidence of hemorrhagic complication. This technology is important for reducing neurologic deficit associated with stroke and increasing the fraction of eligible patients who actually receive thrombolytic therapy. PROPOSED COMMERCIAL APPLICATIONS: This proposal comprises a platform for development of a Doppler ultrasound device which monitors cerebral blood flow velocity and concurrently enhances the thrombolytic effect of t-PA. The product produced will be specifically targeted at hospital emergency services. TCD is the only modality that exists for real time detection of cerebral blood flow during the early stages of stroke. No commercially available modality currently exists for enhancing thrombolytic therapy with ultrasound.