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首页> 外文期刊>Journal of stroke and cerebrovascular diseases: The official journal of National Stroke Association >In Vitro Evaluation of Focused Ultrasound-Enhanced TNK-Tissue Plasminogen Activator-Mediated Thrombolysis
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In Vitro Evaluation of Focused Ultrasound-Enhanced TNK-Tissue Plasminogen Activator-Mediated Thrombolysis

机译：聚焦超声增强TNK组织纤溶酶原激活物介导的溶栓的体外评估

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Introduction: The low and incomplete recanalization performance of thrombolytic therapy in patients with acute ischemic stroke has created the need to use focused ultrasound (FUS) energy as a way to enhance thrombolysis efficiency (sonothrombolysis). Using an in vitro flow model, the role of various parameters involved in FUS-enhanced tenecteplase (TNK-tPA [tissue plasminogen activator])mediated thrombolysis was evaluated. Materials and methods: Fully retracted porcine blood clots were used for the proposed parametric studies. A spherically FUS transducer (4 cm diameter), focusing at 10 cm and operating at 1 MHz, was used. Pulsed ultrasound protocols were applied that maintained temperature elevation at the focus that never exceeded 1 degrees C. Thrombolysis efficiency was measured as the relative reduction in the mass of the clot. Results: The role of various properties on thrombolysis efficacy was examined. These various properties are the acoustic power, the TNK-tPA concentration, the flow rate, the exposure time, the pulse length, the pulse repetition frequency, the duty factor, the formation of standing waves, the acoustic medium, and the administration of microbubbles. Study results have demonstrated that the parameters examined influenced thrombolysis efficacy and the degree of thrombolysis achieved by each parameter was measured. Conclusions: Study findings helped us to optimize the treatment protocol for 1 MHz pulsed FUS that maximizes the thrombolytic efficacy of TNK-tPA, which potentially could be applied for therapeutic purposes. The outcome of the study showed poor thrombolysis efficacy, as with 30 minutes of FUS treatment only 370 mg of clot was removed.
机译：简介：急性缺血性卒中患者溶栓治疗的再通功能低下和不完全，导致需要使用聚焦超声（FUS）能量来提高溶栓效率（sonothrombolysis）。使用体外流动模型，评估了FUS增强的替奈普酶（TNK-tPA [组织纤溶酶原激活物]）介导的溶栓过程中各种参数的作用。材料和方法：将完全缩回的猪血块用于拟议的参数研究。使用球形FUS换能器（直径4厘米），聚焦在10厘米，工作在1 MHz。应用脉冲超声方案，以保持焦点处的温度升高不超过1摄氏度。溶栓效率的测定是血块质量的相对降低。结果：检查了各种性质对溶栓功效的作用。这些不同的特性是声功率，TNK-tPA浓度，流速，暴露时间，脉冲长度，脉冲重复频率，占空比，驻波的形成，声介质和微泡的施用。研究结果表明，所检查的参数影响了溶栓效果，并测量了每个参数实现的溶栓程度。结论：研究结果帮助我们优化了1 MHz脉冲FUS的治疗方案，从而最大程度地提高了TNK-tPA的溶栓效果，可潜在地用于治疗目的。研究结果显示溶栓效果不佳，因为在进行FUS治疗30分钟后，仅去除了370 mg凝块。

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