Contrast‐enhanced sonothrombolysis in acute ischemic stroke patients without intracranial large‐vessel occlusion

Contrast‐enhanced sonothrombolysis (CEST) leads to a more rapid recanalization in acute ischemic stroke caused by intracranial large‐vessel occlusion (LVO). Animal studies have shown that CEST also may be safe and efficient in treating the ischemic microcirculation in the absence of LVO. The exact mechanism behind this treatment effect is not known. We aimed to assess safety and efficacy of CEST in acute ischemic stroke patients included in the Norwegian Sonothrombolysis in Acute Stroke Study (NOR‐SASS) without LVO on admission CT angiography (CTA).

[1]  Hester F. Lingsma,et al.  Two‐Year Outcome after Endovascular Treatment for Acute Ischemic Stroke , 2017, The New England journal of medicine.

[2]  H. Naess,et al.  NOR-SASS (Norwegian Sonothrombolysis in Acute Stroke Study) , 2017, Stroke.

[3]  Y. Liao,et al.  Microbubble-Mediated Sonothrombolysis Improves Outcome After Thrombotic Microembolism-Induced Acute Ischemic Stroke , 2016, Stroke.

[4]  M. Kaps,et al.  Sonothrombolysis with BR38 Microbubbles Improves Microvascular Patency in a Rat Model of Stroke , 2016, PloS one.

[5]  H. Naess,et al.  A pragmatic approach to sonothrombolysis in acute ischaemic stroke: the Norwegian randomised controlled sonothrombolysis in acute stroke study (NOR-SASS) , 2015, BMC Neurology.

[6]  C. Hansen,et al.  Stroke Severity and Incidence of Acute Large Vessel Occlusions in Patients with Hyper-Acute Cerebral Ischemia: Results from a Prospective Cohort Study Based on CT-Angiography (CTA) , 2015, International journal of stroke : official journal of the International Stroke Society.

[7]  Hester F. Lingsma,et al.  MR CLEAN, a multicenter randomized clinical trial of endovascular treatment for acute ischemic stroke in the Netherlands: study protocol for a randomized controlled trial , 2014, Trials.

[8]  H. Naess,et al.  The Norwegian tenecteplase stroke trial (NOR-TEST): randomised controlled trial of tenecteplase vs. alteplase in acute ischaemic stroke , 2014, BMC Neurology.

[9]  A. Alexandrov,et al.  The Role of Sonolysis and Sonothrombolysis in Acute Ischemic Stroke: A Systematic Review and Meta‐analysis of Randomized Controlled Trials and Case‐Control Studies , 2014, Journal of neuroimaging : official journal of the American Society of Neuroimaging.

[10]  H. Naess,et al.  Is higher body temperature beneficial in ischemic stroke patients with normal admission CT angiography of the cerebral arteries? , 2014, Vascular health and risk management.

[11]  B. Kissela,et al.  Eligibility for Intravenous Recombinant Tissue-Type Plasminogen Activator Within a Population: The Effect of the European Cooperative Acute Stroke Study (ECASS) III Trial , 2012, Stroke.

[12]  M. Hennerici,et al.  Progress in sonothrombolysis for the treatment of stroke. , 2012, Stroke.

[13]  A. Alexandrov,et al.  Safety and Efficacy of Ultrasound-Enhanced Thrombolysis: A Comprehensive Review and Meta-Analysis of Randomized and Nonrandomized Studies , 2010, Stroke.

[14]  I. König,et al.  Sonothrombolysis With Transcranial Color-Coded Sonography and Recombinant Tissue-Type Plasminogen Activator in Acute Middle Cerebral Artery Main Stem Occlusion: Results From a Randomized Study , 2008, Stroke.

[15]  Theodor Landis,et al.  Microbubble potentiated transcranial duplex ultrasound enhances IV thrombolysis in acute stroke , 2008, Journal of Thrombosis and Thrombolysis.

[16]  Raquel Delgado-Mederos,et al.  Microbubble administration accelerates clot lysis during continuous 2-MHz ultrasound monitoring in stroke patients treated with intravenous tissue plasminogen activator. , 2006, Stroke.

[17]  A. Alexandrov,et al.  Ultrasound-enhanced systemic thrombolysis for acute ischemic stroke. , 2004, The New England journal of medicine.

[18]  C. Francis,et al.  Ultrasound energy improves myocardial perfusion in the presence of coronary occlusion. , 2004, Journal of the American College of Cardiology.

[19]  A. Alexandrov,et al.  Ischemic Stunning of the Brain: Early Recanalization Without Immediate Clinical Improvement in Acute Ischemic Stroke , 2004, Stroke.

[20]  C. Francis,et al.  Ultrasound Improves Tissue Perfusion in Ischemic Tissue through a Nitric Oxide Dependent Mechanism , 2002, Thrombosis and Haemostasis.

[21]  J V Braaten,et al.  Ultrasound Reversibly Disaggregates Fibrin Fibers , 1997, Thrombosis and Haemostasis.

[22]  J. Hallenbeck,et al.  Temporal impairment of microcirculatory perfusion following focal cerebral ischemia in the spontaneously hypertensive rat , 1997, Brain Research.

[23]  J. Koziol,et al.  Fibrin Contributes to Microvascular Obstructions and Parenchymal Changes During Early Focal Cerebral Ischemia and Reperfusion , 1994, Stroke.

[24]  H. Naess,et al.  Randomized Controlled Contrast-Enhanced Sonothrombolysis in an Unselected Acute Ischemic Stroke Population , 2016 .