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ASA: Combo Clot-Busting Therapy Beneficial in Stroke

Sonothrombolysis with microspheres and tPA may lead to better outcomes than tPA alone

FRIDAY, Feb. 20 (HealthDay News) -- In acute stroke patients, sonothrombolysis with microspheres and tPA may be associated with higher rates of early recanalization and clinical recovery than treatment with tPA alone, according to research presented at the American Stroke Association's International Stroke Conference held Feb. 17 to 20 in San Diego.

Carlos A. Molina, M.D., Ph.D., of Vall d'Hebron Hospital in Barcelona, Spain, and colleagues randomly assigned 35 stroke patients to receive sonothrombolysis with microspheres at a dose of either 1.4 mL or 2.8 mL and tPA or tPA alone.

The researchers found that symptomatic intracerebral hemorrhage did not occur in either the group receiving microspheres at a dose of 1.4 mL or in the tPA alone group. But they observed three such hemorrhages, two of them fatal, in the group receiving microspheres at a dose of 2.8 mL. They also found that sustained complete recanalization rates were higher in both of the microspheres-treated groups (67 percent and 46 percent, respectively) than in the tPA-alone group (33 percent). After three months, favorable outcomes were observed in 75 percent of the 1.4 mL group, 50 percent of the 2.8 mL group, and 36 percent of the tPA-alone group.

"Perflutren-lipid microspheres can be safely combined with systemic tPA and ultrasound at a dose of 1.4mL," the authors conclude. "Safety concerns in the second dose tier may necessitate extended enrollment and further experiments to determine the mechanisms how microspheres interact with tissues."

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