PMID- 29068044
OWN - NLM
STAT- MEDLINE
DCOM- 20180628
LR  - 20181202
IS  - 1600-0404 (Electronic)
IS  - 0001-6314 (Linking)
VI  - 137
IP  - 2
DP  - 2018 Feb
TI  - Contrast-enhanced sonothrombolysis in acute ischemic stroke patients without 
      intracranial large-vessel occlusion.
PG  - 256-261
LID - 10.1111/ane.12861 [doi]
AB  - BACKGROUND: Contrast-enhanced sonothrombolysis (CEST) leads to a more rapid 
      recanalization in acute ischemic stroke caused by intracranial large-vessel 
      occlusion (LVO). Animal studies have shown that CEST also may be safe and 
      efficient in treating the ischemic microcirculation in the absence of LVO. The 
      exact mechanism behind this treatment effect is not known. We aimed to assess 
      safety and efficacy of CEST in acute ischemic stroke patients included in the 
      Norwegian Sonothrombolysis in Acute Stroke Study (NOR-SASS) without LVO on 
      admission CT angiography (CTA). METHODS: NOR-SASS was a randomized controlled 
      trial of CEST in ischemic stroke patients treated with intravenous thrombolysis 
      within 4.5 hours after stroke onset. Patients were randomized to either CEST or 
      sham CEST. In this study, patients were excluded if they had partial or total 
      occlusion on admission CTA, ultrasound-resistant bone window, had received CEST 
      with incorrect insonation as compared to stroke location on Magnetic resonance 
      imaging (MRI), or were stroke mimics. RESULTS: Of the 183 patients included in 
      NOR-SASS, a total of 83 (45.4%) patients matched the inclusion criteria, of which 
      40 received CEST and 43 sham CEST. There were no patients with symptomatic 
      intracranial hemorrhage (sICH) in the CEST group. Rates of asymptomatic ICH, 
      microbleeds, and mortality were not increased in the CEST group. Neurological 
      improvement at 24 hours and functional outcome at 90 days were similar in both 
      groups. CONCLUSION: CEST is safe in ischemic stroke patients without intracranial 
      LVO. There were no differences in clinical outcomes between the treatment groups.
CI  - (c) 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
FAU - Kvistad, C E
AU  - Kvistad CE
AUID- ORCID: 0000-0002-8393-2772
AD  - Department of Neurology, Haukeland University Hospital, Bergen, Norway.
FAU - Nacu, A
AU  - Nacu A
AD  - Department of Neurology, Haukeland University Hospital, Bergen, Norway.
FAU - Novotny, V
AU  - Novotny V
AUID- ORCID: 0000-0002-9137-3894
AD  - Department of Neurology, Haukeland University Hospital, Bergen, Norway.
FAU - Logallo, N
AU  - Logallo N
AD  - Department of Neurology, Haukeland University Hospital, Bergen, Norway.
FAU - Waje-Andreassen, U
AU  - Waje-Andreassen U
AD  - Department of Neurology, Haukeland University Hospital, Bergen, Norway.
FAU - Naess, H
AU  - Naess H
AD  - Department of Neurology, Haukeland University Hospital, Bergen, Norway.
FAU - Thomassen, L
AU  - Thomassen L
AD  - Department of Neurology, Haukeland University Hospital, Bergen, Norway.
LA  - eng
PT  - Clinical Trial, Phase III
PT  - Journal Article
PT  - Randomized Controlled Trial
DEP - 20171025
PL  - Denmark
TA  - Acta Neurol Scand
JT  - Acta neurologica Scandinavica
JID - 0370336
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Female
MH  - Humans
MH  - Male
MH  - Microbubbles/therapeutic use
MH  - Middle Aged
MH  - Norway
MH  - Recovery of Function
MH  - Stroke/pathology/*therapy
MH  - Thrombolytic Therapy/adverse effects/*methods
MH  - Ultrasonography, Doppler, Transcranial/*methods
OTO - NOTNLM
OT  - ischemic stroke
OT  - microbubbles
OT  - microcirculation
OT  - sonothrombolysis
OT  - thrombolysis
EDAT- 2017/10/27 06:00
MHDA- 2018/06/29 06:00
CRDT- 2017/10/26 06:00
PHST- 2017/10/06 00:00 [accepted]
PHST- 2017/10/27 06:00 [pubmed]
PHST- 2018/06/29 06:00 [medline]
PHST- 2017/10/26 06:00 [entrez]
AID - 10.1111/ane.12861 [doi]
PST - ppublish
SO  - Acta Neurol Scand. 2018 Feb;137(2):256-261. doi: 10.1111/ane.12861. Epub 2017 Oct 
      25.