Sonothrombolysis is effective with recombinant tissue-type plasminogen activator, but not with Abciximab

Jürgen Eggers; Stefan Ossadnik; Heiko Hütten; Günter Seidel

doi:10.1160/TH09-03-0207

Thrombosis and Haemostasis, Table of Contents

Thromb Haemost 2009; 102(06): 1274-1277
DOI: 10.1160/TH09-03-0207

New Technologies, Diagnostic Tools and Drugs

Schattauer GmbH

Sonothrombolysis is effective with recombinant tissue-type plasminogen activator, but not with Abciximab

Results from an in vitro study with whole blood clots and platelet-rich clots

Jürgen Eggers

¹Department of Neurology, Asklepios Hospital North, Hamburg, Germany

,

Stefan Ossadnik

²Department of Neurology, University Hospital Schleswig-Holstein, Campus Lübeck, Germany

,

Heiko Hütten

³Department of Haematology and Oncology, Sana Hospital, Lübeck, Germany

,

Günter Seidel

²Department of Neurology, University Hospital Schleswig-Holstein, Campus Lübeck, Germany

› Author Affiliations

Abstract

Summary

Transcranial “diagnostic” ultrasound (US) has been shown to accelerate thrombolysis related to recombinant tissue-type plasminogen activator (rt-PA). In this in vitro study, we evaluated the potential of US to increase clot dissolution mediated by Abciximab (Abc) compared to rt-PA. The effect of 1.8-MHz pulsed wave (PW) Doppler US on dissolution of whole venous blood clots (WBC) and platelet-rich clots (PRC) treated with Abc and rt-PA was investigated in an in vitro model. Clot dissolution was measured by weight loss. Abc-related WBC dissolution was enhanced by additional US, but the effect was not any more detectable when the US was attenuated by a human temporal bone (US-tb). In PRC there was no additional effect of US on the Abc-related clot lysis. Rt-PA-related clot dissolution was increased by US in WBC and PRC as well, however, US-tb was only effective in WBC. The effect of insonation on WBC dissolution treated with the combination of Abc plus rt-PA was lower compared with those treated with rt-PA. In this in vitro experiment, the additional effect of “diagnostic” US in combination with Abc was only present in WBC and less strong than with rt-PA. The results do not support the use of Abc for sonothrombolysis targeting both, fibrin-rich and platelet-rich clots. In contrast, US when combined with rt-PA increases dissolution in both, WBC and PRC as well.

Keywords

Transcranial Doppler ultrasound - thrombolysis - stroke

Full Text

References

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