Please use this identifier to cite or link to this item: https://scholarbank.nus.edu.sg/handle/10635/130065
Title: Ultrasound assisted thrombolysis in acute ischaemic stroke: Preliminary experience in Singapore
Authors: Sharma, V.K. 
Rathakrishnan, R. 
Ong, B.K.C. 
Chan, B.P.L.
Keywords: Acute ischaemic stroke
Thrombolysis
Transcranial doppler
Issue Date: Sep-2008
Citation: Sharma, V.K., Rathakrishnan, R., Ong, B.K.C., Chan, B.P.L. (2008-09). Ultrasound assisted thrombolysis in acute ischaemic stroke: Preliminary experience in Singapore. Annals of the Academy of Medicine Singapore 37 (9) : 778-782. ScholarBank@NUS Repository.
Abstract: Background and Aim: Intravenously-administered tissue plasminogen activator (IV-TPA) induces thrombolysis and remains the only FDA-approved therapy for acute ischaemic stroke. IV-TPA thrombolysis has been approved recently in Singapore for acute stroke. Continuous exposure of clot to 2-MHz pulsed-wave transcranial Doppler (TCD) ultrasound during IV-TPA infusion is known to augment thrombolysis. We aimed to determine the feasibility, safety and efficacy of ultrasound-assisted thrombolysis in acute ischaemic stroke in Singapore. Subjects and Methods: Consecutive patients with acute ischaemic stroke due to intracranial arterial-occlusions were treated with standard IV-tPA and continuously monitored with 2-MHz TCD according to the CLOTBUST-trial protocol. Arterial recanalisation was determined with Thrombolysis in Brain Ischemia (TIBI) flow-grading system. Safety and efficacy of ultrasound-assisted thrombolysis were assessed by rates of symptomatic intracranial haemorrhage (sICH) and functional recovery at 1 month, respectively. Results: Five consecutive patients (mean age 58 years, 3 men and 3 of Chinese ethnicity) were included. Mean time elapsed between symptom onset and presentation to emergency room was 98 minutes (range, 50 to 135 minutes) while the mean time interval between symptom onset to IV-TPA bolus was 144 minutes (range, 125 to 180 minutes). Partial or complete recanalisation with reduction in the stroke severity was noted in 4 out of the 5 patients during IV-TPA infusion (mean change in NIHSS = 4 points; range 2 to 8 points). None of our patients developed sICH while 4 patients demonstrated good functional outcome at 1 month. Conclusions: Our preliminary study demonstrates the feasibility, safety and efficacy of ultrasound-assisted thrombolysis in acute ischaemic stroke in Singapore. Continuous TCD-monitoring during IV-TPA infusion provides real-time information, enhances thrombolysis and improves functional outcomes in acute ischaemic stroke.
Source Title: Annals of the Academy of Medicine Singapore
URI: http://scholarbank.nus.edu.sg/handle/10635/130065
ISSN: 03044602
Appears in Collections:Staff Publications

Show full item record
Files in This Item:
There are no files associated with this item.

Page view(s)

39
checked on Oct 11, 2019

Google ScholarTM

Check


Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.