Sonotrombolisis en el ataque cerebrovascular isquémico: once años de experiencia en Clínica Alemana de Santiago
Date
2014
Type:
Artículo
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7
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ORCID:
Journal Title
Journal ISSN
Volume Title
Publisher
Sociedad Médica de Santiago
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Abstract
Background: Sonothrombolysis (ST) is an emerging modality for the
treatment of stroke. Aim: To assess the feasibility to perform ST in a Chilean
hospital. Material and Methods: Patients 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. Results: One 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). Conclusions: ST can be
carried out in a complex medical center and is safe.
Description
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Citation
Revista Médica de Chile 2014, vol.142,p.1238-1244
Keywords
Stroke, Therapy, Doppler, Thrombolytic Therapy, Ultrasonography