Journal article

Combined contrast-enhanced ultrasound and rt-PA treatment is safe and improves impaired microcirculation after reperfusion of middle cerebral artery occlusion


Authors listNedelmann, Max; Ritschel, Nouha; Doenges, Simone; Langheinrich, Alexander C.; Acker, Till; Reuter, Peter; Yeniguen, Mesut; Pukropski, Jan; Kaps, Manfred; Mueller, Clemens; Bachmann, Georg; Gerriets, Tibo

Publication year2010

Pages1712-1720

JournalJournal of Cerebral Blood Flow & Metabolism

Volume number30

Issue number10

ISSN0271-678X

Open access statusGreen

DOI Linkhttps://doi.org/10.1038/jcbfm.2010.82

PublisherSAGE Publications


Abstract
In monitoring of recanalization and in sonothrombolysis, contrast-enhanced ultrasound (CEUS) is applied in extended time protocols. As extended use may increase the probability of unwanted effects, careful safety evaluation is required. We investigated the safety profile and beneficial effects of CEUS in a reperfusion model. Wistar rats were subjected to filament occlusion of the right middle cerebral artery (MCA). Reperfusion was established after 90 minutes, followed by recombinant tissue-type plasminogen activator (rt-PA) treatment and randomization to additional CEUS (contrast agent: SonoVue; 60 minutes). Blinded outcome evaluation consisted of magnetic resonance imaging (MRI), neurologic assessment, and histology and, in separate experiments, quantitative 3D nano-computed tomography (CT) angiography (900nm(3) voxel size). Nano-CT revealed severely compromised microcirculation in untreated animals after MCA reperfusion. The rt-PA partially improved hemispheric perfusion. Impairment was completely reversed in animals receiving rt-PA and CEUS. This combination was more effective than treatment with either CEUS without rt-PA or rt-PA and ultrasound or ultrasound alone. In MRI experiments, CEUS and rt-PA treatment resulted in a significantly reduced ischemic lesion volume and edema formation. No unwanted effects were detected on MRI, histology, and intracranial temperature assessment. This study shows that CEUS and rt-PA is safe in the situation of reperfusion and displays beneficial effects on the level of the microvasculature. Journal of Cerebral Blood Flow & Metabolism (2010) 30, 1712-1720; doi:10.1038/jcbfm.2010.82; published online 9 June 2010



Citation Styles

Harvard Citation styleNedelmann, M., Ritschel, N., Doenges, S., Langheinrich, A., Acker, T., Reuter, P., et al. (2010) Combined contrast-enhanced ultrasound and rt-PA treatment is safe and improves impaired microcirculation after reperfusion of middle cerebral artery occlusion, Journal of Cerebral Blood Flow & Metabolism, 30(10), pp. 1712-1720. https://doi.org/10.1038/jcbfm.2010.82

APA Citation styleNedelmann, M., Ritschel, N., Doenges, S., Langheinrich, A., Acker, T., Reuter, P., Yeniguen, M., Pukropski, J., Kaps, M., Mueller, C., Bachmann, G., & Gerriets, T. (2010). Combined contrast-enhanced ultrasound and rt-PA treatment is safe and improves impaired microcirculation after reperfusion of middle cerebral artery occlusion. Journal of Cerebral Blood Flow & Metabolism. 30(10), 1712-1720. https://doi.org/10.1038/jcbfm.2010.82



Keywords


ACUTE ISCHEMIC-STROKEHEMORRHAGIC TRANSFORMATIONmicrobubblesMicrocirculationreperfusionSONOGRAPHYsonothrombolysisTISSUE-PLASMINOGEN ACTIVATOR

Last updated on 2025-10-06 at 09:56