Doppler sonography enhances rtPA-induced fibrinolysis in an in vitro clot model of spontaneous intracerebral hemorrhages

dc.contributor.authorMasomi-Bornwasser, Julia
dc.contributor.authorWinter, Philipp
dc.contributor.authorNeulen, Axel
dc.contributor.authorKantelhardt, Sven Rainer
dc.contributor.authorKönig, Jochem
dc.contributor.authorKempski, Oliver
dc.contributor.authorRingel, Florian
dc.contributor.authorKeric, Naureen
dc.date.accessioned2019-07-11T05:50:10Z
dc.date.available2019-07-11T07:50:10Z
dc.date.issued2019
dc.description.abstractBackground Transcranial Doppler (TCD) was shown to enhance intravascular fibrinolysis by rtPA in ischemic stroke. Studies revealed that catheter-based administration of rtPA induces lysis of intracerebral intracerebral hemorrhages (ICH). However, it is unknown whether TCD would be suitable to enhance rtPA rtPA-induced fibrinolysis in patients with ICH. The aim of this study was to assess the potential of of TCD to enhance rtPA-induced fibrinolysis in an in vitro clot system. Methods Reproducible human human blood clots of 25 ml were incubated in a water bath at 37°C during treatments. They were weighed weighed before and after 6 different treatments: (I) control (incubation only), (II) rtPA only, (III) one Doppler probe, (IV) two Doppler probes placed vis-à-vis, (V) one probe and rtPA and (VI) two probes and rtPA. To quantify lysis of the blood clots and attenuation of the Doppler through a temporal temporal squama acoustic peak rarefaction pressure (APRP) was measured in the field of the probes. Temperature Temperature was assessed to evaluate possible side effects. Results Clot weight was reduced in all groups. The control group had the highest relative end weight of 70.2%±7.2% compared to all other other groups (p<0,0001). Most efficient lysis was achieved using (VI) 2 probes and rtPA 36.3%±4.4% compared compared to (II, III, IV) (p<0.0001; p = 0.0002; p = 0.048). APRP was above lysis threshold (535.5±7.2 kPa) using 2 probes even through the temporal squama (731.6±32.5 kPa) (p = 0.0043). There There was a maximal temperature elevation of 0.17±0.07°C using both probes. Conclusions TCD significantly significantly enhances rtPA-induced lysis of blood clots, and the effect is amplified by using multiple probes. Our results indicate that bitemporal TCD insonation of hematomas could be a new and safe approach to enhance fibrinolysis of ICH´s treated with intralesional catheter and rtPA.en_GB
dc.description.sponsorshipDFG, Open Access-Publizieren Universität Mainz / Universitätsmedizin
dc.identifier.doihttp://doi.org/10.25358/openscience-176
dc.identifier.urihttps://openscience.ub.uni-mainz.de/handle/20.500.12030/178
dc.identifier.urnurn:nbn:de:hebis:77-publ-591453
dc.language.isoeng
dc.rightsCC-BY-4.0de_DE
dc.rights.urihttps://creativecommons.org/licenses/by/4.0/
dc.subject.ddc610 Medizinde_DE
dc.subject.ddc610 Medical sciencesen_GB
dc.titleDoppler sonography enhances rtPA-induced fibrinolysis in an in vitro clot model of spontaneous intracerebral hemorrhagesen_GB
dc.typeZeitschriftenaufsatzde_DE
jgu.journal.issue1
jgu.journal.titlePLOS ONE
jgu.journal.volume14
jgu.organisation.departmentFB 04 Medizin
jgu.organisation.nameJohannes Gutenberg-Universität Mainz
jgu.organisation.number2700
jgu.organisation.placeMainz
jgu.organisation.rorhttps://ror.org/023b0x485
jgu.pages.alternativee0210810
jgu.publisher.doi10.1371/journal.pone.0210810
jgu.publisher.issn1932-6203
jgu.publisher.namePLOS
jgu.publisher.placeSan Francisco, California, US
jgu.publisher.urihttp://dx.doi.org/10.1371/journal.pone.0210810
jgu.publisher.year2019
jgu.rights.accessrightsopenAccess
jgu.subject.ddccode610
jgu.type.dinitypeArticle
jgu.type.resourceText
jgu.type.versionPublished versionen_GB
opus.affiliatedNeulen, Axel
opus.affiliatedKantelhardt, Sven Rainer
opus.affiliatedKönig, Jochem
opus.affiliatedKempski, Oliver
opus.affiliatedRingel, Florian
opus.affiliatedKeric, Naureen
opus.date.accessioned2019-07-11T05:50:10Z
opus.date.available2019-07-11T07:50:10
opus.date.modified2019-08-06T09:48:15Z
opus.identifier.opusid59145
opus.institute.number0442
opus.institute.number0441
opus.institute.number0424
opus.metadataonlyfalse
opus.organisation.stringFB 04: Medizin: Institut für Neurochirurgische Pathophysiologiede_DE
opus.organisation.stringFB 04: Medizin: Neurochirurgische Klinik und Poliklinikde_DE
opus.organisation.stringFB 04: Medizin: Institut für Med. Biometrie, Epidemologie und Informatikde_DE
opus.subject.dfgcode00-000
opus.type.contenttypeKeinede_DE
opus.type.contenttypeNoneen_GB

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