ULTRASOUND ENHANCED THROMBOLYSIS AND MONITOR

近年来的研究表明，在溶栓剂如t-PA或尿激酶存在的情况下，超声可促进凝块溶解。本研究的创新之处在于将这些进展应用于人类大脑中动脉的兔股动脉模型中，以开发一种无创且经济有效的脑卒中溶栓监测和治疗方法。Spencer Technologies的数字多普勒技术的进步，使得一种新的双重方法可以监测脑动脉再通的程度，同时通过超声增强溶栓剂的活性。这两种活动——监测和治疗强化——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模式显示器轻松定位脑循环，这种格式很容易向不是多普勒超声专家的医疗专业人员传授。体外超声增强溶栓剂的作用，可减少恢复脑梗死区血流所需的溶栓剂，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功能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：该提案包括一个多普勒超声设备的开发平台，该设备可以监测脑血流速度，同时增强t-PA的溶栓作用。生产的产品将专门针对医院急诊服务。TCD是脑卒中早期实时检测脑血流的唯一方法。目前还没有商业上可用的超声增强溶栓治疗的方法。

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.