Sonothrombolysis is effective with recombinant tissue-type plasminogen activator, but not with Abciximab. Results from an in vitro study with whole blood clots and platelet-rich clots.
Transcranial "diagnostic" ultrasound (US) has been shown to accelerate thrombolysis related to recombinant tissue-type plasminogen activator (rt-PA). In this in vitro study, we evaluated the potential of US to increase clot dissolution mediated by Abciximab (Abc) compared to rt-PA. The effect of 1.8-MHz pulsed wave (PW) Doppler US on dissolution of whole venous blood clots (WBC) and platelet-rich clots (PRC) treated with Abc and rt-PA was investigated in an in vitro model. Clot dissolution was measured by weight loss. Abc-related WBC dissolution was enhanced by additional US, but the effect was not any more detectable when the US was attenuated by a human temporal bone (US-tb). In PRC there was no additional effect of US on the Abc-related clot lysis. Rt-PA-related clot dissolution was increased by US in WBC and PRC as well, however, US-tb was only effective in WBC. The effect of insonation on WBC dissolution treated with the combination of Abc plus rt-PA was lower compared with those treated with rt-PA. In this in vitro experiment, the additional effect of "diagnostic" US in combination with Abc was only present in WBC and less strong than with rt-PA. The results do not support the use of Abc for sonothrombolysis targeting both, fibrin-rich and platelet-rich clots. In contrast, US when combined with rt-PA increases dissolution in both, WBC and PRC as well.
Eggers
Jürgen
J
Department of Neurology, Asklepios Hospital North, Hamburg, Germany. juergeneggers@gmx.net
Ossadnik
Stefan
S
Hütten
Heiko
H
Seidel
Günter
G
D000077284:Abciximab; D000911:Antibodies, Monoclonal / Q000494:pharmacology*; D001777:Blood Coagulation / Q000187:drug effects; D003131:Combined Modality Therapy; D005343:Fibrinolytic Agents / Q000494:pharmacology*; D006801:Humans; D007140:Immunoglobulin Fab Fragments / Q000494:pharmacology*; D066298:In Vitro Techniques; D011994:Recombinant Proteins / Q000494:pharmacology; D020521:Stroke / Q000188:drug therapy / Q000628:therapy; D015912:Thrombolytic Therapy / Q000379:methods*; D013927:Thrombosis / Q000188:drug therapy / Q000628:therapy; D010959:Tissue Plasminogen Activator / Q000494:pharmacology*; D014464:Ultrasonic Therapy / Q000379:methods*
D000911:Antibodies, Monoclonal; D005343:Fibrinolytic Agents; D007140:Immunoglobulin Fab Fragments; D011994:Recombinant Proteins; D010959:Tissue Plasminogen Activator; D000077284:Abciximab