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. 2018 Feb 8;13(2):e0191788.
doi: 10.1371/journal.pone.0191788. eCollection 2018.

Microbubbles combined with ultrasound therapy in ischemic stroke: A systematic review of in-vivo preclinical studies

Laurent Auboire  1   2 , Charles A Sennoga  1 , Jean-Marc Hyvelin  3 , Fréderic Ossant  1   4 , Jean-Michel Escoffre  1 , François Tranquart  5 , Ayache Bouakaz  1
Affiliations

Microbubbles combined with ultrasound therapy in ischemic stroke: A systematic review of in-vivo preclinical studies

Laurent Auboire et al. PLoS One. .

Abstract

Background: Microbubbles (MBs) combined with ultrasound sonothrombolysis (STL) appears to be an alternative therapeutic strategy for acute ischemic stroke (IS), but clinical results remain controversial.

Objective: The aim of this systematic review is to identify the parameters tested; to assess evidence on the safety and efficacy on preclinical data on STL; and to assess the validity and publication bias.

Methods: Pubmed® and Web of ScienceTM databases were systematically searched from January 1995 to April 2017 in French and English. We included studies evaluating STL on animal stroke model. This systematic review was conducted in accordance with the PRISMA guidelines. Data were extracted following a pre-defined schedule by two of the authors. The CAMARADES criteria were used for quality assessment. A narrative synthesis was conducted.

Results: Sixteen studies met the inclusion criteria. The result showed that ultrasound parameters and types of MBs were heterogeneous among studies. Numerous positive outcomes on efficacy were found, but only four studies demonstrated superiority of STL versus recombinant tissue-type plasminogen activator on clinical criteria. Data available on safety are limited.

Limitations: Quality assessment of the studies reviewed revealed a number of biases.

Conclusion: Further in vivo studies are needed to demonstrate a better efficacy and safety of STL compared to currently approved therapeutic options.

Systematic review registration: http://syrf.org.uk/protocols/.

PubMed Disclaimer

Conflict of interest statement

Competing Interests: Bracco Suisse SA provided support in the form of salaries for author [JMH], Advice-US consulting provided support in the form of salaries for author [FT]. Bracco Suisse SA and Advice-US consulting did not have any additional role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. The specific roles of these authors are articulated in the ‘author contributions’ section. This does not alter our adherence to PLOS ONE policies on sharing data and materials.

Figures

Fig 1
Fig 1. PRISMA 2009 flow diagram.
Extracting schedule of the studies.
See this image and copyright information in PMC

References

    1. Feigin VL, Forouzanfar MH, Krishnamurthi R, Mensah GA, Connor M, Bennett DA, et al. Global and regional burden of stroke during 1990–2010: findings from the Global Burden of Disease Study 2010. Lancet. 2014;383(9913):245–54. Epub 2014/01/23. doi: 10.1016/S0140-6736(13)61953-4 ; PubMed Central PMCID: PMCPMC4181600. - DOI - PMC - PubMed
    1. National Institute of Neurological Disorders and Stroke rt-PA Stroke Study Group. Tissue plasminogen activator for acute ischemic stroke. N Engl J Med. 1995;333(24):1581–7. Epub 1995/12/14. doi: 10.1056/NEJM199512143332401 . - DOI - PubMed
    1. Campbell BC, Mitchell PJ, Kleinig TJ, Dewey HM, Churilov L, Yassi N, et al. Endovascular therapy for ischemic stroke with perfusion-imaging selection. N Engl J Med. 2015;372(11):1009–18. Epub 2015/02/12. doi: 10.1056/NEJMoa1414792 . - DOI - PubMed
    1. Berkhemer OA, Fransen PS, Beumer D, van den Berg LA, Lingsma HF, Yoo AJ, et al. A randomized trial of intraarterial treatment for acute ischemic stroke. N Engl J Med. 2015;372(1):11–20. Epub 2014/12/18. doi: 10.1056/NEJMoa1411587 . - DOI - PubMed
    1. Huang X, Cheripelli BK, Lloyd SM, Kalladka D, Moreton FC, Siddiqui A, et al. Alteplase versus tenecteplase for thrombolysis after ischaemic stroke (ATTEST): a phase 2, randomised, open-label, blinded endpoint study. Lancet Neurol. 2015;14(4):368–76. Epub 2015/03/03. doi: 10.1016/S1474-4422(15)70017-7 . - DOI - PubMed

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