ULTRASOUND ENHANCED THROMBOLYSIS AND MONITOR

近年来的研究表明，超声可以增强血栓溶解剂，如t-PA或尿激酶的存在下，血块溶解。本提案的创新之处在于，在人大脑中动脉的活体兔股动脉模型中探索这些进展，以开发一种无创且经济有效的卒中溶栓监测和治疗方法。Spencer Technologies的数字多普勒技术的进步实现了一种新的双重方法来监测脑动脉再通的程度，同时用超声增强溶栓剂的活性。这两种活动-监测和治疗增强-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，这种格式很容易教授给不是多普勒超声专家的医疗专业人员。预计使用外部超声增强溶血栓剂的性能将导致恢复大脑梗塞区域血流所需的溶血栓剂减少，从而降低出血并发症的发生率。这项技术对于减少与卒中相关的神经功能缺损和增加实际接受溶栓治疗的合格患者比例非常重要。拟议的商业应用：该提案包括一个平台，用于开发多普勒超声设备，该设备监测脑血流速度，同时增强t-PA的溶栓效果。生产的产品将专门针对医院紧急服务。TCD是唯一存在的真实的时间检测脑血流在中风的早期阶段。目前还没有商业上可获得的方式存在用于增强超声溶栓治疗。

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.