BACKGROUND Ultrasound (US) has been used to enhance thrombolytic therapy in the treatment of stroke. Considerable attenuation of US intensity is however noted if US is applied over the temporal bone. The aim of this study was therefore to explore possible changes in the effect of thrombolytic drugs during low-intensity, high-frequency continuous-wave ultrasound (CW-US) exposure. METHODS Clots...

nfarction is the most intensively studied medical intervention in the history of clinical investigation, with more than 200 000 patients enrolled in large scale, worldwide trials. The results of these trials have led to an irrevocably altered approach, with routine use of reperfusion treatment. Streptokinase, tissue plasminogen activator (t-PA), and new plas-minogen activators have been shown t...

TREATMENT OF ACUTE STROKE At the University at Buffalo Department of Neurosurgery, endovascular technique for the treatment of acute stroke has evolved with laboratory research, participation in clinical trials, and clinical experience (Table 20.1). From 1994 to 1996, the primary method of treatment was intra-arterial (IA) injection of urokinase or prourokinase. In 1997, IA injection of tissue ...

Do Not Substitute: IV Thrombolytic Selection Errors in Acute Stroke To the Editor: Activase (alteplase), commonly referred to as tPA, is a tissue-type plasminogen activator approved for treatment of ischemic stroke when given within 3 hours of symptom onset. Of the 6 thrombolytic drugs licensed for any use in the United States, Retaplase (reteplase), and TNKase (tenecteplase) share this mechani...

Do Not Substitute: IV Thrombolytic Selection Errors in Acute Stroke To the Editor: Activase (alteplase), commonly referred to as tPA, is a tissue-type plasminogen activator approved for treatment of ischemic stroke when given within 3 hours of symptom onset. Of the 6 thrombolytic drugs licensed for any use in the United States, Retaplase (reteplase), and TNKase (tenecteplase) share this mechani...