Combined contrast-enhanced ultrasound and rt-PA treatment is safe and improves impaired microcirculation after reperfusion of middle cerebral artery occlusion

Nedelmann, Max; Ritschel, Nouha; Doenges, Simone; Langheinrich, Alexander C.; Acker, Till; Reuter, P.; Yeniguen, Mesut; Pukropski, Jan; Kaps, Manfred; Mueller, Clemens; Bachmann, Georg; Gerriets, Tibo

doi:10.1038/jcbfm.2011.58

Cited by 22 publications

(9 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Even in the absence of parent artery recanalization, microbubbles and ultrasound still improve microcirculation status (Nedelmann et al . ). Third, ultrasonic opening of blood‐brain barrier may also improve intracerebral focal delivery of systemically administered agents (Baseri et al .…”

Section: Sonothrombolysismentioning

confidence: 97%

Transcranial Doppler ultrasound in neurovascular diseases: diagnostic and therapeutic aspects

Topçuoğlu

2012

Journal of Neurochemistry

View full text Add to dashboard Cite

Albeit no direct anatomical information can be obtained, neurosonological methods provide real-time determination of velocity, and spectral waveform of blood flow in basal intracranial arteries adds significant benefit to the care of the patients with neurovascular diseases. Several features, such as relative simplicity in terms of interpretation and performance, significantly low cost, totally non-invasiveness, portability, and excellent temporal resolution, make neurosonology increasingly popular tool for evaluation, planning, and monitoring of treatment, and for determining prognosis in various neurovascular diseases. Usefulness of transcranial Doppler in diagnosing/monitoring subarachnoid hemorrhage related vasospasm and sickle cell vasculopathy is already well known. Utility in diagnosis of intracranial arterial stenosis, acute occlusion and recanalization, intracranial hemodynamic effect of the cervical arterial pathologies, intracranial pressure increase, and cerebral circulatory arrest are also well established. Neurosonological determination of vasomotor reactivity, cerebral autoregulation, neurovascular coupling, and micro-embolic signals detection are useful in the assessment of stroke risk, diagnosis of right-to-left shunting, and monitoring during surgery and interventional procedures. Transcranial Doppler is also an evolving ultrasound method with a therapeutic potential such as augmentation of clot lysis and cerebral delivery of thrombolytic or neuroprotective agent loaded nanobubbles in neurovascular diseases. The aim of this study is to give an overview of current usage of the different ultrasound modalities in different neurovascular diseases.

show abstract

Section: Sonothrombolysismentioning

confidence: 97%

Transcranial Doppler ultrasound in neurovascular diseases: diagnostic and therapeutic aspects

Topçuoğlu

2012

Journal of Neurochemistry

View full text Add to dashboard Cite

show abstract

“…Factor XII deficiency of plasmatic coagulation cascade is known to reduce infarction size which bases on altered tissue haemostasis (22). Also, tPA affects microcirculation and haemostasis in ischaemic tissue as shown recently by Nedelmann et al (23). In their reperfusion mice model, restoration of microcirculation after brain infarction depends on applying tPA, while reperfusion alone did not diminish infarction size.…”

Section: Discussionmentioning

confidence: 92%

“…Also, tPA affects microcirculation and haemostasis in ischaemic tissue as shown recently by Nedelmann et al . (23). In their reperfusion mice model, restoration of microcirculation after brain infarction depends on applying tPA, while reperfusion alone did not diminish infarction size.…”

Section: Discussionmentioning

confidence: 99%

Treatment with tPA Predicts Better Outcome Even if MCA Occlusion Persists

Kablau¹,

Alonso²,

Hennerici³

et al. 2012

International Journal of Stroke

View full text Add to dashboard Cite

Although the prognosis of patients with persisting middle cerebral artery occlusion after tissue plasminogen activator administration is known to be poor, patients do better if treated with tissue plasminogen activator vs. those who could not be treated - mainly for late presentation. This may be due to sufficient small vascular territory recanalization despite persistence of large artery occlusion after tissue plasminogen activator treatment.

show abstract

“…In the routine setting, contrast‐enhanced TCCS is accepted as a safe diagnostic method for evaluation of the intracranial arteries in acute stroke . Moreover, in an experimental model made up of Wistar rats subjected to filament occlusion of the right MCA, combined contrast‐enhanced ultrasound, and rt‐PA treatment was shown to be safe . However, the current stroke treatment for patients with an anterior circulation LAO has been recently modified based on the results of five RCTs (MR CLEAN, ESCAPE, REVASCAT, SWIFT PRIME, and EXTEND IA) .…”

Section: Discussionmentioning

confidence: 99%

“…31,32 Moreover, in an experimental model made up of Wistar rats subjected to filament occlusion of the right MCA, combined contrast-enhanced ultrasound, and rt-PA treatment was shown to be safe. 33 However, the current stroke treatment for patients with an anterior circulation LAO has been recently modified based on the results of five RCTs (MR CLEAN, ESCAPE, REVASCAT, SWIFT PRIME, and EXTEND IA). 5 Therefore, our concern was a potential increased risk of ICH in patients receiving SonoVue R on top of rt-PA and/or thrombectomy.…”

Section: Discussionmentioning

confidence: 99%

Safety and Tolerability of SonoVue® in Patients with Large Artery Anterior Circulation Acute Stroke

Baracchini

Viaro

Favaretto

et al. 2016

Journal of Neuroimaging

View full text Add to dashboard Cite

show abstract

Combined contrast-enhanced ultrasound and rt-PA treatment is safe and improves impaired microcirculation after reperfusion of middle cerebral artery occlusion

Cited by 22 publications

References 29 publications

Transcranial Doppler ultrasound in neurovascular diseases: diagnostic and therapeutic aspects

Transcranial Doppler ultrasound in neurovascular diseases: diagnostic and therapeutic aspects

Treatment with tPA Predicts Better Outcome Even if MCA Occlusion Persists

Safety and Tolerability of SonoVue® in Patients with Large Artery Anterior Circulation Acute Stroke

Contact Info

Product

Resources

About