Incidence of @entity548 linked to treatment of @entity385 with recombinant tissue plasminogen activator (rt-PA) has led to interest in adjuvant therapies such as ultrasound (US) or plasminogen, to enhance rt-PA efficacy and improve @entity1 safety. High-frequency US (   MHz) such as 2-MHz transcranial Doppler (TCD) has demonstrated increased recanalization in situ. Low-frequency US (   kHz) enhanced thrombolysis (UET) has demonstrated higher lytic capabilities but has been associated with incidence of @entity1779 in some clinical trials. In vitro studies using plasminogen have shown enhancement of lysis. This study compared rt-PA-induced lysis using adjuvant therapies, with 120-kHz or 2-MHz pulsed US, or plasminogen, in an in vitro @entity1 whole blood clot model. Blood was drawn from 30 subjects after local institutional approval. Clots were exposed to rt-PA at concentrations of 0 to 3.15  g/ml. Clots were exposed to rt-PA alone (rt-PA) or in combination with plasminogen ( @entity1351 ), 120-kHz US (120-kHz), or 2-MHz US (2-MHz). Thrombolytic efficacy was determined by assessing the percent fractional clot loss (FCL) at 30 minutes using microscopic imaging. There was no enhancement of lysis for combination therapy with [rt-PA]=0  g/ml. Adding rt- PA increased lysis for all groups. As [rt-PA] increased, lysis tended to increase for 120-kHz and @entity1351 (FCL: from 50% to 70%, 120-kHz; 65% to 83%, @entity1351 ) but not for 2-MHz (58% to 52%). Lytic efficacy in combination therapy depends on rt- PA concentration and the adjuvant therapy type. For non-zero rt-PA concentrations, all combination therapies produced more lysis than rt-PA alone.

Combination treatment with rt-PA is more effective than rt-PA alone in an in vitro XXXX clot model.

@entity1 :: ('9606', 'Species') :: ['human', 'patient'] @entity548 :: ('MESH:D006470', 'Disease') :: ['intra-cranial hemorrhage'] @entity1351 :: ('5340', 'Gene') :: ['Plg'] @entity1779 :: ('MESH:D002543', 'Disease') :: ['intracerebral hemorrhage'] @entity385 :: ('MESH:D002544', 'Disease') :: ['ischemic stroke']
@entity1 :: (9606,Species) :: ['human']
