1
|
Viszlayová D, Brozman M, Langová K, Herzig R, Školoudík D. Sonolysis in risk reduction of symptomatic and silent brain infarctions during coronary stenting (SONOREDUCE): Randomized, controlled trial. Int J Cardiol 2018; 267:62-67. [PMID: 29859706 DOI: 10.1016/j.ijcard.2018.05.101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2018] [Revised: 03/22/2018] [Accepted: 05/25/2018] [Indexed: 10/16/2022]
Abstract
BACKGROUND Silent brain infarcts can be detected on magnetic resonance imaging (MRI) in ~22% of patients after coronary angioplasty and stenting (CS). The effect of periprocedural sonolysis on the risk of new brain infarcts during CS was examined. METHODS Patients undergoing elective CS were allocated randomly to a bilateral sonolysis group (70 patients, 58 men; mean age, 59.9 years) or a control group (74 patients, 45 men; mean age, 65.5 years). Neurologic examination, cognitive function tests, and brain MRI were performed prior to intervention and at 24 h after CS. Neurologic examination and cognitive function tests were repeated at 30 days after CS. RESULTS No significant differences were observed in the number of patients with new infarcts (25.7 vs. 18.9%, P = 0.423), the number of lesions (1.3 ± 1.0 vs. 2.9 ± 5.3, P = 0.493), lesion volume (0.16 ± 0.34 vs. 0.28 ± 0.60 mL, P = 0.143), and the number of patients with new ischemic lesions in the insonated MCA territories (18.6vs. 17.6%, P = 0.958) between the sonolysis group and the control group. There were no cases of stroke, transient ischemic attack, myocardial infarction, or death in the two groups. Intracranial bleeding was reported only in 1 patient in the control group (0 vs. 1.4%, P = 0.888). Clock-drawing test scores at 30 days were significantly higher in the sonolysis group than in the control group (median 3.0 vs. 2.5, P = 0.031). CONCLUSIONS Sonolysis does not reduce the risk of new brain infarcts after CS. The effect of sonolysis on number and volume of ischemic lesions and cognitive function should be assessed in further studies.
Collapse
Affiliation(s)
- Daša Viszlayová
- Department of Neurology, Faculty Hospital Nitra and Constantine Philosopher University, Nitra, Slovakia; Department of Neurology, Faculty of Medicine and Dentistry, Palacký University, Olomouc, Czech Republic; Department of Neurology, Charles University Faculty of Medicine, Hradec Králové, Czech Republic
| | - Miroslav Brozman
- Department of Neurology, Faculty Hospital Nitra and Constantine Philosopher University, Nitra, Slovakia
| | - Kateřina Langová
- Centre for Research and Science, Faculty of Health Sciences, Palacký University, Olomouc, Czech Republic; Department of Biophysics, Faculty of Medicine and Dentistry, Palacký University, Olomouc, Czech Republic
| | - Roman Herzig
- Department of Neurology, Comprehensive Stroke Center, Charles University Faculty of Medicine and University Hospital Hradec Králové, Hradec Králové, Czech Republic
| | - David Školoudík
- Centre for Research and Science, Faculty of Health Sciences, Palacký University, Olomouc, Czech Republic.
| | | |
Collapse
|
2
|
Papadopoulos N, Kyriacou PA, Damianou C. Review of Protocols Used in Ultrasound Thrombolysis. J Stroke Cerebrovasc Dis 2017; 26:2447-2469. [DOI: 10.1016/j.jstrokecerebrovasdis.2017.07.032] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2016] [Revised: 07/01/2017] [Accepted: 07/30/2017] [Indexed: 01/01/2023] Open
|
3
|
Hrbáč T, Netuka D, Beneš V, Nosáľ V, Kešnerová P, Tomek A, Fadrná T, Beneš V, Fiedler J, Přibáň V, Brozman M, Langová K, Herzig R, Školoudík D. SONOlysis in prevention of Brain InfaRctions During Internal carotid Endarterectomy (SONOBIRDIE) trial - study protocol for a randomized controlled trial. Trials 2017; 18:25. [PMID: 28095924 PMCID: PMC5240392 DOI: 10.1186/s13063-016-1754-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2016] [Accepted: 12/12/2016] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Carotid endarterectomy (CEA) is a beneficial procedure for selected patients with an internal carotid artery (ICA) stenosis. Surgical risk of CEA varies from between 2 and 15%. The aim of the study is to demonstrate the safety and effectiveness of sonolysis (continual transcranial Doppler monitoring, TCD) using a 2-MHz diagnostic probe with maximal diagnostic energy on the reduction of the incidence of stroke, transient ischemic attack (TIA) and brain infarction detected using magnetic resonance imaging (MRI) by the activation of the endogenous fibrinolytic system during CEA. METHODS/DESIGN Design: a multicenter, randomized, double-blind, sham-controlled trial. SCOPE international, multicenter trial for patients with at least 70% symptomatic or asymptomatic ICA stenosis undergoing CEA. INCLUSION CRITERIA patients with symptomatic or asymptomatic ICA stenosis of at least 70% are candidates for CEA; a sufficient temporal bone window for TCD; aged 40-85 years, functionally independent; provision of signed informed consent. Randomization: consecutive patients will be assigned to the sonolysis or control (sham procedure) group by computer-generated 1:1 randomization. Prestudy calculations showed that a minimum of 704 patients in each group is needed to reach a significant difference with an alpha value of 0.05 (two-tailed) and a beta value of 0.8 assuming that 10% would be lost to follow-up or refuse to participate in the study (estimated 39 endpoints). ENDPOINTS the primary endpoint is the incidence of stroke or TIA during 30 days after CEA and the incidence of new ischemic lesions on brain MRI performed 24 h after CEA in the sonolysis and control groups. Secondary endpoints are occurrence of death, any stroke, or myocardial infarction within 30 days, changes in cognitive functions 1 year post procedure related to pretreatment scores, and number of new lesions and occurrence of new lesions ≥0.5 mL on post-procedural brain MRI. ANALYSIS descriptive statistics and linear/logistic multiple regression models will be performed. Clinical relevance will be measured as relative risk reduction, absolute risk reduction and the number needed to treat. DISCUSSION Reduction of the periprocedural complications of CEA using sonolysis as a widely available and cheap method may significantly increase the safety of CEA and extend the indication criteria for CEA. TRIAL REGISTRATION ClinicalTrials.gov, NCT02398734 . Registered on 20 March 2015.
Collapse
Affiliation(s)
- Tomáš Hrbáč
- Department of Neurosurgery, Comprehensive Stroke Center, University Hospital Ostrava, Ostrava, Czech Republic
| | - David Netuka
- Department of Neurosurgery and Neurooncology, Comprehensive Stroke Center, Military University Hospital, Prague, Czech Republic
| | - Vladimír Beneš
- Department of Neurosurgery and Neurooncology, Comprehensive Stroke Center, Military University Hospital, Prague, Czech Republic
| | - Vladimír Nosáľ
- Department of Neurology, Jessenius Faculty of Medicine in Martin, Comenius University, Bratislava, Slovak Republic
| | - Petra Kešnerová
- Department of Neurology, Comprehensive Stroke Center, 2nd Faculty of Medicine, Charles University in Prague and Motol University Hospital, Prague, Czech Republic
| | - Aleš Tomek
- Department of Neurology, Comprehensive Stroke Center, 2nd Faculty of Medicine, Charles University in Prague and Motol University Hospital, Prague, Czech Republic
| | - Táňa Fadrná
- Department of Neurosurgery, Comprehensive Stroke Center, University Hospital Ostrava, Ostrava, Czech Republic
- Center for Research and Science, Faculty of Health Sciences, Palacký University Olomouc, Olomouc, Czech Republic
| | - Vladimír Beneš
- Department of Neurosurgery, Comprehensive Stroke Center, Liberec Hospital, Liberec, Czech Republic
| | - Jiří Fiedler
- Department of Neurosurgery, Comprehensive Stroke Center, České Budějovice Hospital, České Budějovice, Czech Republic
- Department of Neurosurgery, Comprehensive Stroke Center, University Hospital Plzeň, Plzeň, Czech Republic
| | - Vladimír Přibáň
- Department of Neurosurgery, Comprehensive Stroke Center, University Hospital Plzeň, Plzeň, Czech Republic
| | - Miroslav Brozman
- Department of Neurology, Faculty Hospital Nitra, Constantine Philosopher University Nitra, Nitra, Slovakia
| | - Kateřina Langová
- Center for Research and Science, Faculty of Health Sciences, Palacký University Olomouc, Olomouc, Czech Republic
- Department of Biophysics, Faculty of Medicine and Dentistry, Institute of Molecular and Translational Medicine, Palacký University, Olomouc, Czech Republic
| | - Roman Herzig
- Department of Neurosurgery and Neurooncology, Comprehensive Stroke Center, Military University Hospital, Prague, Czech Republic
- Department of Neurology, Comprehensive Stroke Center, Charles University Faculty of Medicine and University Hospital Hradec Králové, Hradec Králové, Czech Republic
| | - David Školoudík
- Center for Research and Science, Faculty of Health Sciences, Palacký University Olomouc, Olomouc, Czech Republic
- Department of Neurology, Comprehensive Stroke Center, University Hospital Ostrava, Ostrava, Czech Republic
| |
Collapse
|
4
|
Školoudík D, Kuliha M, Hrbáč T, Jonszta T, Herzig R. Sonolysis in Prevention of Brain Infarction During Carotid Endarterectomy and Stenting (SONOBUSTER): a randomized, controlled trial. Eur Heart J 2016; 37:3096-3102. [DOI: 10.1093/eurheartj/ehv492] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/30/2023] Open
|
5
|
Školoudík D, Hurtíková E, Brát R, Herzig R. Sonolysis in Prevention of Brain Infarction During Cardiac Surgery (SONORESCUE): Randomized, Controlled Trial. Medicine (Baltimore) 2016; 95:e3615. [PMID: 27196464 PMCID: PMC4902406 DOI: 10.1097/md.0000000000003615] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/29/2016] [Revised: 04/06/2016] [Accepted: 04/13/2016] [Indexed: 11/26/2022] Open
Abstract
Here, we examined whether intraoperative sonolysis can alter the risk of new ischemic lesions in the insonated brain artery territory during coronary artery bypass grafting (CABG) or valve surgery.Silent brain ischemic lesions could be detected in as many as two-thirds of patients after CABG or valve surgery.Patients indicated for CABG or valve surgery were allocated randomly to sonolysis (60 patients, 37 males; mean age, 65.3 years) of the right middle cerebral artery (MCA) during cardiac surgery and control group (60 patients, 37 males; mean age, 65.3 years). Neurologic examination, cognitive function tests, and brain magnetic resonance imaging (MRI) were conducted before intervention as well as 24 to 72 hours and 30 days after surgery.New ischemic lesions on control diffusion-weighted MRI in the insonated MCA territory ≥0.5 mL were significantly less frequent in the sonolysis group than in the control group (13.3% vs 26.7%, P = 0.109). The sonolysis group exhibited significantly reduced median volume of new brain ischemic lesions (P = 0.026). Stenosis of the internal carotid artery ≥50% and smoking were independent predictors of new brain ischemic lesions ≥0.5 mL (odds ratio = 5.685 [1.272-25.409], P = 0.023 and 4.698 [1.092-20.208], P = 0.038, respectively). Stroke or transient ischemic attack occurred only in 2 control patients (P = 0.496). No significant differences were found in scores for postintervention cognitive tests (P > 0.05).This study provides class-II evidence that sonolysis during CABG or valve surgery reduces the risk of larger, new ischemic lesions in the brain.www.clinicaltrials.gov (NCT01591018).
Collapse
Affiliation(s)
- David Školoudík
- From the Department of Neurology, Comprehensive Stroke Center, University Hospital Ostrava, Ostrava (DS, EH); Faculty of Health Sciences, Palacký University, Olomouc (DS); Department of Cardiac Surgery, University Hospital Ostrava, Ostrava (RB), and Department of Neurosurgery and Neurooncology, Comprehensive Stroke Center, Military University Hospital, Prague (RH), Czech Republic
| | | | | | | |
Collapse
|
6
|
Abstract
Thrombo-occlusive disease is a leading cause of morbidity and mortality. In this chapter, the use of ultrasound to accelerate clot breakdown alone or in combination with thrombolytic drugs will be reported. Primary thrombus formation during cardiovascular disease and standard treatment methods will be discussed. Mechanisms for ultrasound enhancement of thrombolysis, including thermal heating, radiation force, and cavitation, will be reviewed. Finally, in-vitro, in-vivo and clinical evidence of enhanced thrombolytic efficacy with ultrasound will be presented and discussed.
Collapse
Affiliation(s)
- Kenneth B Bader
- Division of Cardiovascular Health and Disease, Department of Internal Medicine, College of Medicine, University of Cincinnati, Cincinnati, OH, USA
| | - Guillaume Bouchoux
- Division of Cardiovascular Health and Disease, Department of Internal Medicine, College of Medicine, University of Cincinnati, Cincinnati, OH, USA
| | - Christy K Holland
- Division of Cardiovascular Health and Disease, Department of Internal Medicine, College of Medicine, University of Cincinnati, Cincinnati, OH, USA.
| |
Collapse
|
7
|
de Saint Victor M, Crake C, Coussios CC, Stride E. Properties, characteristics and applications of microbubbles for sonothrombolysis. Expert Opin Drug Deliv 2014; 11:187-209. [DOI: 10.1517/17425247.2014.868434] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
|
8
|
Kuliha M, Roubec M, Jonszta T, Krajca J, Czerny D, Krajina A, Langová K, Herzig R, Procházka V, Školoudík D. Safety and efficacy of endovascular sonolysis using the EkoSonic endovascular system in patients with acute stroke. AJNR Am J Neuroradiol 2013; 34:1401-6. [PMID: 23370469 DOI: 10.3174/ajnr.a3416] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Sonolysis is a new therapeutic procedure for arterial recanalization. The aim of this study was to confirm the safety and efficacy of endovascular sonolysis by using the EkoSonic Endovascular System in subjects with acute ischemic stroke. MATERIALS AND METHODS Patients with acute ischemic stroke with occlusion of the middle cerebral artery or basilar artery were enrolled consecutively in this prospective study. The control group (44 MCA and 12 BA occlusions) was selected from historical controls. EkoSonic Endovascular System was started within 8 hours after stroke onset. The NIHSS score at hospital admission, after 24 hours, and at 7 days; arterial recanalization; early neurologic improvement; symptomatic intracerebral hemorrhage; and favorable 3-month clinical outcome defined as a modified Rankin Scale score of 0-2 were evaluated by statistical means. RESULTS Fourteen patients (10 men; mean age, 65.1 ± 11.2 years; median NIHSS score, 16.5) underwent EkoSonic endovascular sonolysis. Arterial recanalization after endovascular treatment was achieved in 6 of 7 (85.7%) patients with MCA occlusion (4 complete recanalizations) and in all 7 (100%) patients with BA occlusion (6 complete recanalizations). No (0%) symptomatic intracerebral hemorrhage or periprocedural complications occurred. Seven (50%) patients were independent at 3 months (median mRS score, 2). Early neurologic improvement and favorable clinical outcome were significantly more frequent in patients with MCA occlusion undergoing EkoSonic endovascular sonolysis than in controls (100% and 71.4% versus 4.6% and 13.6% of patients; P = .0001 and P = .003, respectively). Three-month mortality was significantly lower in patients with BA occlusion undergoing EkoSonic endovascular sonolysis than in controls (0% versus 66.7% patients, P = .013). CONCLUSIONS In this small study, EkoSonic endovascular sonolysis allowed safe and potentially effective revascularization in patients experiencing acute ischemic stroke.
Collapse
Affiliation(s)
- M Kuliha
- Comprehensive Stroke Center, Department of Neurology, Faculty of Medicine, Ostrava University and University Hospital Ostrava, Ostrava, Czech Republic
| | | | | | | | | | | | | | | | | | | |
Collapse
|
9
|
Saqqur M, Tsivgoulis G, Nicoli F, Skoloudik D, Sharma VK, Larrue V, Eggers J, Perren F, Charalampidis P, Storie D, Shuaib A, Alexandrov AV. The role of sonolysis and sonothrombolysis in acute ischemic stroke: a systematic review and meta-analysis of randomized controlled trials and case-control studies. J Neuroimaging 2013; 24:209-20. [PMID: 23607713 DOI: 10.1111/jon.12026] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2012] [Revised: 03/05/2013] [Accepted: 03/11/2013] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVES To assess the evidence on the safety and efficacy of sonothrombolysis in acute stroke. SEARCH METHODS Electronic databases and grey literature were searched under different MeSH terms from 1970 to present. SELECTION CRITERIA Randomized control trials (RCTs) and case control studies (CCSs) on sonolysis and sonothrombolysis alone or with microsphere in acute stroke patients (>18 old). Outcome measures included complete recanalization (CR) at 1-2 and 24 hours, 3 months modified Rankin Scale (mRS), and symptomatic intracerebral hemorrhage (sICH). Data was extracted to Review Manager software. RESULTS Fifty-seven studies were retrieved and analyzed. Ten studies (7 RCTs and 3 CCSs) were included in our meta-analysis, which revealed that sonolysis and sonothrombolysis are safe (OR of sICH: 1.14; 95% confidence interval (CI): 0.56- 2.34;P=0.71) and effective (OR of CR at 1-2 hours: 2.95;95% CI: 1.81-4.81;P<0.00001) and have more than two-fold higher likelihood of favourable long-term outcome (3-month mRS 0-2; OR: 2.20; CI:1.52-3.19;P<0.0001). Further subgroup analysis based on the presence of microsphere revealed that it is safe (OR of sICH: 1.18; CI:0.433.24;P=0.75) and effective (OR of CR: 2.61; CI: 1.36-4.99;P=0.004). Subgroup analysis based on sonolysis revealed to be safe and effective. CONCLUSIONS This novel treatment appears safe and effective. The evidence of microsphere as an enhancement of sonothrombolysis is evolving.
Collapse
Affiliation(s)
- Maher Saqqur
- From the Department of Medicine (Neurology), University of Alberta, Edmonton, Alberta, Canada
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
10
|
Roubec M, Kuliha M, Procházka V, Krajča J, Czerný D, Jonszta T, Krajina A, Šaňák D, Langová K, Herzig R, Školoudík D. A Controlled Trial of Revascularization in Acute Stroke. Radiology 2013; 266:871-878. [DOI: 10.1148/radiol.12120798] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023]
|
11
|
Bardon P, Kuliha M, Herzig R, Kanovsky P, Skoloudik D. Safety and efficacy of sonothrombolysis using bilateral TCD monitoring by diagnostic 2 MHz probes - a pilot study. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 2012; 158:233-7. [PMID: 23128815 DOI: 10.5507/bp.2012.064] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2012] [Accepted: 06/13/2012] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION Sonothrombolysis is a new treatment method for patients with acute ischemic stroke (IS). Various ultrasound frequencies and intensities are being tested these days. The aim of this pilot study was to assess the safety and efficacy of sonothrombolysis using 2 diagnostic probes and bilateral monitoring in patients with acute occlusion of the middle cerebral artery (MCA). PATIENTS AND METHODS Twelve consecutive IS patients (7 males; age 47 - 78, average 64.1 ± 9.4 years) with acute MCA occlusion and contraindication of thrombolysis were included in the study. 60-min bilateral 2-MHz pulsed-wave Doppler monitoring of the area of occlusion was performed in all patients (Group 1). The control group consisted of 37 IS patients (20 males; age 32 - 78, average 62.2 ± 12.1 years) treated with standard sonothrombolysis and selected from the Thrombotripsy Study database (Group 2). The differences in number of recanalized arteries after a 1 h treatment, independent patients (modified Rankin scale [mRS] value of 0 - 2) after 90 days and symptomatic intracerebral hemorrhages (SICH) were statistically evaluated. RESULTS Complete recanalization was found in 4 (30.0%) Group 1 and in 12 (32.4%) Group 2 patients. Seven (58.3%) Group 1 and 22 (59.5%) Group 2 patients were independent after 90 days. SICH was found in none of Group 1 patients and in 1 (2.7%) of the Group 2 patients (P>0.05 in all cases). CONCLUSION In this pilot study, sonothrombolysis using 2 probes and bilateral monitoring is safe but not more effective than standard sonothrombolysis in acute IS patients with MCA occlusion.
Collapse
Affiliation(s)
- Petr Bardon
- Department of Neurology, Hospital Trinec-Sosna, Trinec, Czech Republic
| | | | | | | | | |
Collapse
|
12
|
Bardoň P, Kuliha M, Herzig R, Šaňák D, Langová K, Kaňovský P, Školoudík D. Changes in middle cerebral artery blood flow velocity during sonolysis using a diagnostic transcranial probe with a 2-MHz Doppler frequency in healthy volunteers. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2012; 31:1789-1794. [PMID: 23091250 DOI: 10.7863/jum.2012.31.11.1789] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
OBJECTIVES Ultrasound has various biological effects in the human body. The effects of continuous monitoring with ultrasound (sonolysis) on vasodilatation of the radial artery were described recently. We wanted to ascertain whether similar changes in the blood flow velocity during sonolysis could also be detected in the middle cerebral artery. METHODS Fifteen healthy volunteers (6 male and 9 female; age range, 23-68 years; mean ± SD, 47.1 ± 15.1 years) were subjected to 1 hour of middle cerebral artery sonolysis using a diagnostic transcranial probe with a 2-MHz Doppler frequency and measurement of the blood flow velocity at 2-minute intervals. During a second session, a flow curve was recorded for 10 seconds at 2-minute intervals. The peak systolic velocity, end-diastolic velocity, mean flow velocity, pulsatility index, and resistive index were recorded during both measurements. RESULTS Irregular changes in the measured blood flow parameters were recorded during both sessions. Changes in particular hemodynamic parameters during both measurements were similar. The changes in the peak systolic velocity, end-diastolic velocity, mean flow velocity, pulsatility index, and resistive index were not significantly different between the two measurements (P < .05 in all cases). CONCLUSIONS As opposed to sonolysis of the radial artery, sonolysis of the middle cerebral artery using a diagnostic 2-MHz frequency in healthy volunteers did not lead to changes in the flow curve or peripheral vasodilatation.
Collapse
Affiliation(s)
- Petr Bardoň
- Department of Neurology, Hospital Třinec-Sosna, Třinec, Czech Republic
| | | | | | | | | | | | | |
Collapse
|
13
|
Eggers J. Sonothrombolysis for treatment of acute ischemic stroke: Current evidence and new developments. ACTA ACUST UNITED AC 2012. [DOI: 10.1016/j.permed.2012.02.022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
|
14
|
Kuliha M, Roubec M, Fadrná T, Šaňák D, Herzig R, Jonszta T, Czerný D, Krajča J, Procházka V, Školoudík D. Endovascular sono-lysis using EKOS system in acute stroke patients with a main cerebral artery occlusion – A pilot study. ACTA ACUST UNITED AC 2012. [DOI: 10.1016/j.permed.2012.02.055] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
|
15
|
Bardoň P, Skoloudík D, Langová K, Herzig R, Kaňovský P. Changes in blood flow velocity in the radial artery during 1-hour ultrasound monitoring with a 2-MHz transcranial probe--a pilot study. JOURNAL OF CLINICAL ULTRASOUND : JCU 2010; 38:493-496. [PMID: 20806344 DOI: 10.1002/jcu.20732] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
PURPOSE Multiple biologic effects of ultrasound on the human body have been described. Our aim was to monitor changes in blood flow velocities in the radial artery during continuous pulsed wave Doppler monitoring (DM). METHODS Fifteen healthy volunteers (8 males; mean age 55 ± 17 years) underwent two 1-hour sessions of left radial artery DM using a diagnostic transcranial 2-MHz pulsed-wave transducer. Blood flow velocities were recorded twice at 2-minute intervals, for the measurement of peak systolic velocity, end-diastolic velocity, and mean flow velocity, and the calculation of pulsatility index, and resistance index. Insonation was either intermittent (by periods <10 seconds) or continuous during the first session, and conversely during the second session 2 weeks later. RESULTS Blood flow velocities and indices fluctuated during both sessions. These changes were symmetrical during the intermittent DM session. In contrast, end-diastolic velocity increased while pulsatility index and resistance index decreased significantly during the continuous DM session (p < 0.05 for all three parameters). The changes in peak systolic velocity and mean flow velocity did not differ between sessions. CONCLUSIONS One-hour sonographic Doppler monitoring using a 2-MHz diagnostic transcranial PW Doppler probe may induce peripheral vasorelaxation in humans.
Collapse
Affiliation(s)
- Petr Bardoň
- Department of Neurology, Hospital Třinec-Sosna, Třinec, Czech Republic
| | | | | | | | | |
Collapse
|
16
|
Skoloudík D, Fadrná T, Roubec M, Bar M, Zapletal O, Blatný J, Langová K, Bardon P, Sanák D, Kanovský P, Herzig R. Changes in hemocoagulation in acute stroke patients after one-hour sono-thrombolysis using a diagnostic probe. ULTRASOUND IN MEDICINE & BIOLOGY 2010; 36:1052-1059. [PMID: 20620692 DOI: 10.1016/j.ultrasmedbio.2010.04.010] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/01/2009] [Revised: 03/26/2010] [Accepted: 04/16/2010] [Indexed: 05/29/2023]
Abstract
The aim was to monitor the changes in hemocoagulation parameters in acute ischemic stroke (AIS) patients after sono-thrombolysis of the occluded middle cerebral artery using a duplex transcranial probe with 2.0-MHz frequency in Doppler mode. Sixteen AIS patients indicated for intravenous thrombolysis (IVT) (8 males; mean age 68.3 +/- 7.1 y) and 16 AIS patients contraindicated for IVT (11 males; mean age 67.9 +/- 7.9 y) were randomized for sono-thrombolysis (8 + 8 patients) or standard treatment (control group) (8 + 8 patients). The significant decrease of plasminogen activator inhibitor-1, plasminogen and alpha-2-antiplasmin activity by a mean of 60, 32 and 24%, respectively, and the increase of tissue plasminogen activator by a mean of 56% was found after sono-thrombolysis when compared with control group (p < 0.0125); these changes were more evident in patients treated with a combination of sono-thrombolysis and IVT (79, 38, 50 and 82%, respectively) than in patients treated by sono-thrombolysis alone (34, 13, 17 and 30%, respectively).
Collapse
Affiliation(s)
- David Skoloudík
- Department of Neurology, University Hospital, Ostrava, Czech Republic.
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
17
|
Bar M, Školoudík D, Roubec M, Hradílek P, Chmelová J, Czerný D, Procházka V, Langová K, Herzig R. Transcranial Duplex Sonography and CT Angiography in Acute Stroke Patients. J Neuroimaging 2009; 20:240-5. [DOI: 10.1111/j.1552-6569.2008.00358.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
|