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Clinical Apllications - TCD & tPA Treatment


One of the most common and important treatments over the last few years for the immediate treatment of stroke is an intra-venous medicine called tPA (tissue plasminogen activator), tPA is a very powerful "clot-buster" which is given up to the first 4.5 hours after the onset of symptoms, tPA can significantly improve the patient's outcome from the stroke over the long term. The sooner tPA is started, the better the outcome, so time is of the essence.

Digi-Lite Transcranial Doppler (TCD) is the most available bedside tool that is used to determine cerebral arterial occlusion and to continuously monitor recanalization during thrombolysis treatment. TCD has a sensitivity of 91% and a specificity of 93% to determine complete recanalization of the middle cerebral artery (MCA) in tPA-treated patients. Furthermore, continuous clot exposure to ultrasound Doppler signal enhances tPA activity, and clot degradation with ultrasound irradiation is 1.8 times greater than that with tPA alone. In the future, TCD will act as a sonotrombolysis therapeutic tool as well as a diagnostic and monitoring tool.