Ultrasound-aided therapy better than stroke drug alone, t...( ved t-PA alone. Notably 38 percent of...),Health

ved t-PA alone. Notably, 38 percent of the patients who received continuous ultrasound and t-PA showed no blockage within two hours, compared to 13 percent who received t-PA alone. In all, 73 percent of patients who received the combined therapy showed complete or partial clearance of the clot, compared to 50 percent in the control group. Bleeding into the brain was experienced by 4.8 percent of patients in both groups. This early improvement of blood flow to the brain resulted in a trend that 13.5 percent more patients who received continuous ultrasound and t-PA had recovered completely by 3 months after stroke.

The team also found that patients who experienced complete clearance of their clot within 2 hours following treatment had the greatest likelihood of regaining body strength, speech, and other functions affected by stroke. Researchers named the trial CLOTBUST (Combined Lysis Of Thrombus in Brain ischemia Using transcranial ultrasound and Systemic t-PA).

"In the past 30 years, scientists around the world have shown that ultrasound is fast, gentle, and effective in helping t-PA to break up clots. For the first time, we have demonstrated this benefit in patients. This approach enhances flow to the brain and augments clinical recovery within minutes of treatment initiation," said Dr. Alexandrov.

"Stroke can be devastating for patients and their caregivers," said Story C. Landis, Ph.D., NINDS director. "These initial findings suggest that patients who receive the combined therapy are able to leave the hospital with a greater chance for recovery following an ischemic stroke. This is an excellent example of improving on an existing therapy and providing better outcomes."

Ultrasound causes vibrations among the molecules on and within clot structures, which in turn creates more binding sites for t-PA interaction and subsequent clot breakdown. The researchers think that this "jiggle" improves drug transport to and around the c
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Contact: Margo Warren or Paul Girolami
pg100b@nih.gov
301-496-5751
NIH/National Institute of Neurological Disorders and Stroke
17-Nov-2004

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