Microbubble-Mediated Sonothrombolysis Improves Outcome After Thrombotic Microembolism-Induced Acute Ischemic Stroke. Issue 5 (May 2016)

• Record Type: Journal Article
• Authors: Lu, Yongkang; Wang, Junfen; Huang, Ruizhu; Chen, Gangbin; Zhong, Lintao; Shen, Shuxin; Zhang, Chuanxi; Li, Xinzhong; Cao, Shiping; Liao, Wangjun; Liao, Yulin; Bin, Jianping
• Is Part Of: Stroke. Volume 47:Issue 5(2016)
• Publication Date: 2016-05
• Subjects: microbubbles -- thrombolytic therapy -- thrombus -- stroke -- ultrasonics; Cerebrovascular disease -- Periodicals; Cerebral circulation -- Periodicals; 616.81
• DOI: 10.1161/STROKEAHA.115.012056
• Languages: English
• ISSNs: 0039-2499

Abstract

Abstract : Background and Purpose—: Microthrombi originating from disintegrated clots or formed in situ may account for the poor clinical improvement of acute ischemic stroke after recanalization therapy. We attempted to determine whether microbubble-mediated sonothrombolysis could dissolve platelet-rich and erythrocyte-rich microthrombi, thereby reducing their brain injury-causing potential. Methods—: Platelet- and erythrocyte-rich microthrombosis were induced by periadventitial application of 5% ferric chloride or thrombin to mesenteric microvessels in 75 Sprague–Dawley rats. Acute ischemic stroke was induced by intracarotid injection of platelet- or erythrocyte-rich microthrombi in another 50 rats. Rats were randomly divided into control (CON), ultrasound (US), ultrasound and microbubble (US+MB), recombinant tissue-type plasminogen activator (r-tPA), and US+MB+r-tPA groups. The post-treatment mesenteric microvessel recanalization rates, cerebral infarct volumes, and neurological scores were determined. Results—: The recanalization rates of platelet- and erythrocyte-rich microthrombi in mesenteric microvessels were higher ( P <0.05), and the cerebral infarct volumes and neurological scores of rats with either microthrombi were lower in the US+MB group than in the CON group ( P <0.01). The infarct volumes and neurological scores were greater in the r-tPA group than in the US+MB and US+MB+r-tPA groups after treatment of rats with platelet-rich microthrombi ( P <0.05). In contrast, after treatment of rats with erythrocyte-rich microthrombi, the infarct volumes and neurological scores were similar in the r-tPA and US+MB groups, but smaller in the US+MB+r-tPA group ( P <0.05). Conclusions—: Microbubble-mediated sonothrombolysis improved the outcomes of microthrombi-induced acute ischemic stroke. Thus, this method may serve as an attractive adjunct to recanalization therapy for acute ischemic stroke. Abstract : Supplemental Digital Content is available in the text.