In Vitro Examination of the Thrombolytic Efficacy of Desmoteplase and Therapeutic Ultrasound Compared with rt-PA.
The aim of the study described here was to evaluate the thrombolytic efficacy of combined treatment with the fibrin-selective plasminogen activator desmoteplase (DSPA) and therapeutic ultrasound (sonothrombolysis [STL]) compared with conventional rt-PA (recombinant tissue plasminogen activator) treatment in vitro. Lysis rates were determined by the weight loss of platelet-rich plasma (PRP) clots treated with rt-PA (60 kU/mL) or DSPA (2 μg/mL) combined with pulsed wave ultrasound (2 MHz, 0.179 W/cm(2)). To reveal the individual effects of medication and ultrasound, lysis rates were also determined for DSPA monotherapy and for combined treatment with rt-PA and ultrasound. Clots solely placed in plasma served as the control group. Lysis increased significantly with rt-PA (26.5 ± 7.8%) and DSPA (30.5 ± 6%) compared with the control group (18.2 ± 5.9%) (each p < 0.001). DSPA lysis was more effective than rt-PA lysis (without STL: p = 0.015, with STL: p = 0.01). Combined treatment with DSPA and 2-MHz STL significantly exceeded rt-PA lysis (32.8% vs. 26.5%, p < 0.001).
Department of Neurology, University Hospital Giessen, Giessen, Germany. Electronic address: florian.roessler@neuro.med.uni-giessen.de.
Florian C
FC
Roessler
The BioRobotics Institute, Scuola Superiore Sant'Anna and Center for Micro-BioRobotics@SSSA, Istituto Italiano di Tecnologia, Pontedera, Italy.
Zhihua
Z
Wang
Department of Neurology, University Hospital of Schleswig-Holstein, Campus Lübeck, Lübeck, Germany.
Sabrina
S
Schumacher
Department of Neurology, University Hospital of Schleswig-Holstein, Campus Lübeck, Lübeck, Germany.
Marcus
M
Ohlrich
Department of Neurology, University Hospital Giessen, Giessen, Germany.
Manfred
M
Kaps
The BioRobotics Institute, Scuola Superiore Sant'Anna and Center for Micro-BioRobotics@SSSA, Istituto Italiano di Tecnologia, Pontedera, Italy.
Arianna
A
Menciassi
Department of Neurology, Sana Kliniken Lübeck GmbH, Lübeck, Germany.
Jürgen
J
Eggers
D000704:Analysis of Variance; D003131:Combined Modality Therapy; D005343:Fibrinolytic Agents / Q000494:pharmacology*; D006801:Humans; D066298:In Vitro Techniques; D010960:Plasminogen Activators / Q000494:pharmacology*; D015203:Reproducibility of Results; D015912:Thrombolytic Therapy / Q000379:methods*; D013927:Thrombosis / Q000628:therapy*; D010959:Tissue Plasminogen Activator / Q000494:pharmacology*; D014464:Ultrasonic Therapy / Q000379:methods*
D005343:Fibrinolytic Agents; C069588:salivary plasminogen activator alpha 1, Desmodus rotundus; D010960:Plasminogen Activators; D010959:Tissue Plasminogen Activator
Alteplase; Cerebrovascular stroke; Desmoteplase; Fibrin-selective plasminogen activator; In vitro model; Sonothrombolysis; Ultrasound