M. De Lima Oliveira, R. Nogueira, K. Andrade Norremose, A. Maria Negrao Esteves, F. Iuji Yamamoto, E. Faria Evaristo, M. Jacobsen Teixeira, E. Bor-Seng-Shu
Department of Neurology, University Hospital, University of São Paulo – São Paulo, Brazil
Objective: It is supposed that Transcranial Doppler ultrasonography (TCD) during thrombolysis may help to expose thrombi to tissue plasminogen acPvator (t-PA). The aim of this study is to determine if TCD can safely enhance the thrombolyPc acPvity of t-PA.
Material and Methods: Patients with acute ischemic stroke which fufill current criteria to intravenous t-PA treatment were randomly assigned to receive continuous 2 MHz TCD (the target group) or placebo (the control group). In follow up analysis, outcomes are defined as good (as indicated by a score of 0 to 2 on the modified Rankin scale) or favorable (scores of 0 to 1 on modified Rankin Scale).
Results: A total of 108 patients were enrolled to receive continuous ultrasonography (57 patients) or placebo (51 patients). The mean age was 64 in TCD group and 63 years in control group. Mean NIHSS score at admission was 13 in TCD group and 17 in control group. Good outcome was observed in 26 patients in the target group (45,6%) as compared with 19 patients in the controlgroup (37,3%). A favorable outcome occurred in 25 patients in the target group (43.9%) as compared with 15 patients in control group (29.4%).
Discussion: In spite of results without significant statatistical difference (p=0,136), a trend to bether recovery was observed in the target group. TCD may have a role in the improvement of outcomes of patients submitted to thrombolytic approach.
Key words: acute ischemic stroke, patients prognoses, thrombolysis, ultrasound-enhanced.