We found a match
Your institution may have rights to this item. Sign in to continue.
- Title
Intrahematomal Ultrasound Enhances RtPA-Fibrinolysis in a Porcine Model of Intracerebral Hemorrhage.
- Authors
Masomi-Bornwasser, Julia; Heimann, Axel; Schneider, Christian; Klodt, Tristan; Elmehdawi, Hammoud; Kronfeld, Andrea; Krenzlin, Harald; Tanyildizi, Yasemin; Kreitner, Karl-Friedrich; Kempski, Oliver; Sommer, Clemens; Ringel, Florian; Keric, Naureen; Sporns, Peter
- Abstract
Catheter-based ultrasound-thrombolysis has been successfully used in a small clinical trial in order to enhance recombinant tissue plasminogen activator (rtPA)-fibrinolysis, for the treatment of spontaneous intracerebral hemorrhages (ICHs). The aim of this study was to investigate the ultra-early effects of ultrasound on hematoma and the surrounding brain tissue in a porcine ICH-model. To achieve this, 21 pigs with a right frontal ICH were randomly assigned to four groups: (1) drainage (n = 3), (2) drainage + rtPA (n = 6), (3) drainage + ultrasound (n = 6), and (4) drainage + ultrasound + rtPA (n = 6). The hematoma volume assessment was performed using cranial MRI before and after the treatments. Subsequently, the brain sections were analyzed using HE-staining and immunohistochemistry. The combined treatment using rtPA and ultrasound led to a significantly higher hematoma reduction (62 ± 5%) compared to the other groups (Group 1: 2 ± 1%; Group 2: 30 ± 12%; Group 3: 18 ± 8% (p < 0.0001)). In all groups, the MRI revealed an increase in diffusion restriction but neither hyper- or hypoperfusion, nor perihematomal edema. HE stains showed perihematomal microhemorrhages were equally distributed in each group, while edema was more pronounced within the control group. Immunohistochemistry did not reveal any ultra-early side effects. The combined therapy of drainage, rtPA and ultrasound is a safe and effective technique for hematoma-reduction and protection of the perihematomal tissue in regard to ultra-early effects.
- Subjects
ULTRASONIC imaging; CEREBRAL hemorrhage; TISSUE plasminogen activator
- Publication
Journal of Clinical Medicine, 2021, Vol 10, Issue 4, p563
- ISSN
2077-0383
- Publication type
Article
- DOI
10.3390/jcm10040563