{"id":9867,"date":"2009-03-17T01:31:38","date_gmt":"2009-03-17T01:31:38","guid":{"rendered":"http:\/\/cardiophile.org\/?p=1095"},"modified":"2009-03-17T01:31:38","modified_gmt":"2009-03-17T01:31:38","slug":"sonothrombolysis-a-novel-modality-for-treament-of-acute-myocardial-infarction-2","status":"publish","type":"post","link":"https:\/\/johnsonfrancis.org\/professional\/sonothrombolysis-a-novel-modality-for-treament-of-acute-myocardial-infarction-2\/","title":{"rendered":"Sonothrombolysis for treatment of acute MI"},"content":{"rendered":"

Sonothrombolysis for treatment of acute MI<\/span><\/h2>\n

Sonothrombolysis: High mechanical index impulses from a diagnostic ultrasound transducer can be used to break microbubbles within the occluded coronary arteries to produce thrombolysis. A porcine study published in Circulation<\/em> [1] and an accompanying editorial [2] explored this possibility. Though primary angioplasty is the best known therapy for treatment of acute myocardial infarction, most of the persons suffering from acute myocardial infarction in the world do not have timely access to this modality of treatment, even in the developed countries. So if a non invasive modality like this is developed, which can be used even in remote areas, it will be a path breaking success in the management of acute myocardial infarction on a global scale. This study in animals evaluated intravenous glycoprotein IIb\/IIIa\u2013targeted microbubbles (targeting platelets) along with half-dose recombinant prourokinase, heparin and aspirin. The group which received sonothrombolysis in addition to half-dose recombinant prourokinase, heparin and aspirin had better outcome than the group which did not receive it. The accompanying editorial called for more research into this novel modality of treatment.<\/p>\n

Clinical effectiveness of sonothrombolysis in ST elevation myocardial infarction was tested by Wilson Mathias Jr, Jeane M Tsutsui, Bruno G Tavares, Agostina M Fava, Miguel O D Aguiar, Bruno C Borges, Mucio T Oliveira Jr, Alexandre Soeiro, Jose C Nicolau, Henrique B Ribeiro, Hsu Po Chiang, Jo\u00e3o C N Sbano, Abdulrahman Morad, Andrew Goldsweig, Carlos E Rochitte, Bernardo B C Lopes, Jos\u00e9 A F Ramirez, Roberto Kalil Filho and Thomas R Porter, the MRUSMI Investigators [3]. They had 50 patients each in the study group and control group. Study group received sonothrombolysis followed by emergent percutaneous coronary intervention while the control group received only percutaneous coronary intervention. A reference group of 203 patients who present beyond thrombolysis window were also analysed.<\/p>\n

Authors concluded that sonothrombolysis added to percutaneous coronary intervention improve recanalization rates and reduces infarct size. This translated into sustained improvements in left ventricular systolic function.<\/p>\n

References<\/span><\/strong><\/p>\n

    \n
  1. Feng Xie, John Lof, Terry Matsunaga, Reena Zutshi, Thomas R Porter. Diagnostic ultrasound combined with glycoprotein IIb\/IIIa-targeted microbubbles improves microvascular recovery after acute coronary thrombotic occlusions<\/a>. Circulation. 2009 Mar 17;119(10):1378-85.<\/li>\n
  2. Sanjiv Kaul. Sonothrombolysis: a universally applicable and better way to treat acute myocardial infarction and stroke? Who is going to fund the research? Circulation. 2009 Mar 17;119(10):1358-60.<\/li>\n
  3. Wilson Mathias Jr, Jeane M Tsutsui, Bruno G Tavares, Agostina M Fava, Miguel O D Aguiar, Bruno C Borges, Mucio T Oliveira Jr, Alexandre Soeiro, Jose C Nicolau, Henrique B Ribeiro, Hsu Po Chiang, Jo\u00e3o C N Sbano, Abdulrahman Morad, Andrew Goldsweig, Carlos E Rochitte, Bernardo B C Lopes, Jos\u00e9 A F Ramirez, Roberto Kalil Filho, Thomas R Porter, the MRUSMI Investigators. Sonothrombolysis in ST-Segment Elevation Myocardial Infarction Treated With Primary Percutaneous Coronary Intervention<\/a>. J Am Coll Cardiol. 2019 Jun 11;73(22):2832-2842.<\/li>\n<\/ol>\n","protected":false},"excerpt":{"rendered":"

    Sonothrombolysis: High mechanical index impulses from an ultrasound transducer can break microbubbles in occluded coronary arteries and lyse thrombi.<\/p>\n","protected":false},"author":1,"featured_media":37793,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"nf_dc_page":"","footnotes":""},"categories":[18],"tags":[],"class_list":["post-9867","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-angiography-and-interventions"],"yoast_head":"\nSonothrombolysis, a novel modality for treatment of acute MI<\/title>\n<meta name=\"description\" content=\"Sonothrombolysis: High mechanical index impulses from an ultrasound transducer can break microbubbles in occluded coronary arteries and lyse thrombi.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" 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