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首页> 外文期刊>Journal of stroke and cerebrovascular diseases: The official journal of National Stroke Association >The Enhancing Effect of Focused Ultrasound on TNK-Tissue Plasminogen Activator-Induced Thrombolysis Using an In Vitro Circulating Flow Model
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The Enhancing Effect of Focused Ultrasound on TNK-Tissue Plasminogen Activator-Induced Thrombolysis Using an In Vitro Circulating Flow Model

机译：使用体外循环流模型，聚焦超声对TNK组织纤溶酶原激活物诱导的溶栓作用的增强作用

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Background: The limited efficacy of thrombolytic therapy in patients with ischemic stroke has created the need to use focused ultrasound (FUS) energy as a way to enhance thrombolysis efficacy (sonothrombolysis). Using an in vitro circulating flow model, we evaluated the role of physical parameters on tenecteplase (TNK-tPA)-mediated thrombolysis. Materials and Methods: Fully retracted porcine blood clots were used for the proposed experimental study. To provide a more realistic clinical environment of stroke, the study was conducted under realistic flow conditions and TNK-tPA concentrations. Two spherically FUS transducers (4-cm diameter), focusing at 10 cm and operating at .6 and 1.05 MHz, respectively, were used. Pulsed ultrasound protocols that maintained a localized temperature elevation at the focus of 1 degrees C were applied. Thrombolysis efficacy was measured in milligram of mass clot removed. Results: The effect of physical parameters such as temperature, FUS frequency, acoustic power (AP), FUS energy, and microbubble (MB) administration on thrombolysis efficacy was examined. Conclusions: Study findings established that higher FUS frequencies (1 MHz) are associated with enhanced thrombolysis compared to lower FUS frequencies (. 6 MHz). Furthermore, an increase in the linear relationship between AP and thrombolysis efficacy was exhibited. Also, the outcome of the study showed that the combination of 1-MHz FUS pulses with MBs strongly enhanced the enzymatic thrombolytic efficacy of TNK-tPA, because with 30 minutes of treatment, 1050 mg of clot was removed through nonthermal mechanisms. Taking into consideration that stroke is time dependent, this thrombolytic rate should be sufficient for timely recanalization of the occluded cerebral artery.
机译：背景：溶栓疗法在缺血性中风患者中的疗效有限，因此需要使用聚焦超声（FUS）能量作为增强溶栓疗效（sonothrombolysis）的方法。使用体外循环流模型，我们评估了物理参数对替奈普酶（TNK-tPA）介导的溶栓作用的作用。材料和方法：完全缩回的猪血块用于拟议的实验研究。为了提供更现实的中风临床环境，该研究在现实的流动条件和TNK-tPA浓度下进行。使用了两个球形FUS换能器（直径4厘米），分别聚焦在10厘米处，工作频率分别为0.6和1.05 MHz。应用脉冲超声方案，将局部温度升高保持在1℃的焦点上。溶栓效力以除去的血块毫克数进行测量。结果：检查了诸如温度，FUS频率，声功率（AP），FUS能量和微泡（MB）管理等物理参数对溶栓功效的影响。结论：研究发现确定，与较低的FUS频率（。6 MHz）相比，较高的FUS频率（1 MHz）与溶栓作用增强相关。此外，显示出AP与溶栓功效之间的线性关系增加。此外，研究结果表明，将1-MHz FUS脉冲与MB结合使用可大大增强TNK-tPA的酶促溶栓功效，因为在处理30分钟后，通过非热机制清除了1050 mg凝块。考虑到中风是时间依赖性的，该溶栓率应足以及时对闭塞的脑动脉进行再通。

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