[Sonothrombolysis for acute ischemic stroke]

Rev Med Chil. 2014 Oct;142(10):1238-44. doi: 10.4067/S0034-98872014001000002.
[Article in Spanish]

Abstract

Background: Sonothrombolysis (ST) is an emerging modality for the treatment of stroke.

Aim: To assess the feasibility to perform ST in a Chilean hospital.

Material and methods: Patients attended at a private clinic with an acute ischemic stroke, between September 2002 and May 2013 and eligible for endovenous thrombolysis, were studied with a transcranial Doppler (Spencer PMD 100 or 150®). Those with an adequate sonographic window and a demonstrated arterial occlusion were monitored continuously with transcranial Doppler at the site of worst residual flow following the CLOTBUST study protocol.

Results: One thousand twenty six patients were studied, of whom 136 received intravenous thrombolysis (rt-PA) and 61, aged 66 ± 18 years (59% males), were subjected to ST (7% of total). Their median National Institutes of Health Stroke Scale score was 14, the lapse from symptom onset to rt-PA was 127 minutes (43-223). Middle cerebral artery (MCA) occlusion was found in 88.5% of patients. Complete recanalization was achieved in 44.3% of patients. Sixty percent had Modified Rankin Scale of 0 to 2 at 3 months (95% confidence intervals (CI) 48.1 to 72). Case fatality was 9.8% and asymptomatic intracranial hemorrhage occurred in 9.8% (95% CI: 4.3 to 20.2).

Conclusions: ST can be carried out in a complex medical center and is safe.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Brain Ischemia / diagnostic imaging
  • Brain Ischemia / therapy
  • Feasibility Studies
  • Female
  • Humans
  • Male
  • Risk Factors
  • Stroke / diagnostic imaging*
  • Stroke / therapy*
  • Thrombolytic Therapy / instrumentation
  • Thrombolytic Therapy / methods*
  • Ultrasonic Therapy / methods*
  • Ultrasonography, Doppler, Transcranial