• Revista médica de Chile · Oct 2014

    [Sonothrombolysis for acute ischemic stroke].

    • Alejandro Brunser, Arnold Hoppe, Paula Muñoz, Daniel Cárcamo, Pablo M Lavados, Javier Gaete, Andrés Roldán, and Rodrigo Rivas.
    • Rev Med Chil. 2014 Oct 1; 142 (10): 1238-44.

    BackgroundSonothrombolysis (ST) is an emerging modality for the treatment of stroke.AimTo assess the feasibility to perform ST in a Chilean hospital.Material And MethodsPatients attended at a private clinic with an acute ischemic stroke, between September 2002 and May 2013 and eligible for endovenous thrombolysis, were studied with a transcranial Doppler (Spencer PMD 100 or 150®). Those with an adequate sonographic window and a demonstrated arterial occlusion were monitored continuously with transcranial Doppler at the site of worst residual flow following the CLOTBUST study protocol.ResultsOne thousand twenty six patients were studied, of whom 136 received intravenous thrombolysis (rt-PA) and 61, aged 66 ± 18 years (59% males), were subjected to ST (7% of total). Their median National Institutes of Health Stroke Scale score was 14, the lapse from symptom onset to rt-PA was 127 minutes (43-223). Middle cerebral artery (MCA) occlusion was found in 88.5% of patients. Complete recanalization was achieved in 44.3% of patients. Sixty percent had Modified Rankin Scale of 0 to 2 at 3 months (95% confidence intervals (CI) 48.1 to 72). Case fatality was 9.8% and asymptomatic intracranial hemorrhage occurred in 9.8% (95% CI: 4.3 to 20.2).ConclusionsST can be carried out in a complex medical center and is safe.

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