دورية أكاديمية
Feasibility of sonothrombolysis in the ambulance for ST-elevation myocardial infarction.
العنوان: | Feasibility of sonothrombolysis in the ambulance for ST-elevation myocardial infarction. |
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المؤلفون: | El Kadi S; Department of Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam UMC, Location VUmc, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands. s.elkadi@amsterdamumc.nl., Porter TR; Division of Cardiovascular Medicine, University of Nebraska Medical Center, Omaha, NE, USA., Zanstra M; Ambulance Amsterdam, Zaanstreek-Waterland, Zaandam, The Netherlands., Siegers A; Ambulance Amsterdam, Zaanstreek-Waterland, Zaandam, The Netherlands., van Loon RB; Department of Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam UMC, Location VUmc, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands., Hopman LHGA; Department of Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam UMC, Location VUmc, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands., van Rossum AC; Department of Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam UMC, Location VUmc, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands., Kamp O; Department of Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam UMC, Location VUmc, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands. |
المصدر: | The international journal of cardiovascular imaging [Int J Cardiovasc Imaging] 2022 May; Vol. 38 (5), pp. 1089-1098. Date of Electronic Publication: 2021 Dec 07. |
نوع المنشور: | Journal Article |
اللغة: | English |
بيانات الدورية: | Publisher: Springer Country of Publication: United States NLM ID: 100969716 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1875-8312 (Electronic) Linking ISSN: 15695794 NLM ISO Abbreviation: Int J Cardiovasc Imaging Subsets: PubMed not MEDLINE; MEDLINE |
أسماء مطبوعة: | Publication: [New York] : Springer Original Publication: Boston : Kluwer Academic Publishers, c2001- |
مستخلص: | Patients with ST-elevation myocardial infarction (STEMI) due to coronary occlusion require immediate restoration of epicardial and microvascular blood flow. A potentially new reperfusion method is the use of ultrasound and microbubbles, also called sonothrombolysis. The oscillation and collapse of intravenously administered microbubbles upon exposure to high mechanical index (MI) ultrasound pulses results in thrombus dissolution and stimulates nitric oxide-mediated increases in tissue perfusion. The aim of this study was to assess feasibility of sonothrombolysis in the ambulance for STEMI patients. Patients presenting with chest pain and ST-elevations on initial electrocardiogram were included. Sonothrombolysis was applied in the ambulance during patient transfer to the percutaneous coronary intervention (PCI) center. Feasibility was assessed based on duration of sonothrombolysis treatment and number of high MI pulses applied. Vital parameters, ST-resolution, pre- and post-PCI coronary flow and cardiovascular magnetic resonance images were analyzed. Follow up was performed at six months after STEMI. Twelve patients were screened, of which three patients were included in the study. Sonothrombolysis duration and number of high MI pulses ranged between 12 and 17 min and 32-60 flashes respectively. No arrhythmias or changes in vital parameters were observed during and directly after sonothrombolysis, although one patient developed in-hospital ventricular fibrillation 20 min after sonothrombolysis completion but before PCI. In one case, sonothrombolysis on top of regular pre-hospital care resulted in reperfusion before PCI. This is the first report on the feasibility of performing sonothrombolysis to treat myocardial infarction in an ambulance. To assess efficacy and safety of pre-hospital sonothrombolysis, clinical trials with greater patient numbers should be performed. EU Clinical Trials Register (identifier: 2019-001883-31), registered 2020-02-25. (© 2021. The Author(s), under exclusive licence to Springer Nature B.V.) |
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فهرسة مساهمة: | Keywords: Ambulance; Reperfusion; ST-elevation myocardial infarction; Sonothrombolysis; Therapy |
تواريخ الأحداث: | Date Created: 20211208 Latest Revision: 20240531 |
رمز التحديث: | 20240531 |
DOI: | 10.1007/s10554-021-02487-7 |
PMID: | 34877619 |
قاعدة البيانات: | MEDLINE |
تدمد: | 1875-8312 |
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DOI: | 10.1007/s10554-021-02487-7 |