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頁籤選單縮合
題名 | Developing Models of Embolism for Evaluating Anti-thromboembolic Therapies Using Doppler Ultrasound Embolic Signal Detection |
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作者 | Markus,Hugh S; | 書刊名 | Acta Neurologica Taiwanica |
卷期 | 9:1 2000.03[民89.03] |
頁次 | 頁4-8 |
分類號 | 415.92 |
關鍵詞 | 大腦栓塞; 血小板; 超音波; 中風; 頸動脈; Cerebral embolism; Platelets; Ultrasonography; Stroke; Carotid artery diseases; Carotid endarterectomy; |
語文 | 英文(English) |
英文摘要 | Asymptomatic cerebral emboli can be detected using Doppler ultrasound. This technique may allow the construction of models in which the efficacy of different anti-platelet and anticoagulant drugs in humans. This relies on the fact that asymptomatic embolic signals are much more common than stroke and transient ischemic attacks and therefore may provide a useful surrogate endpoint. For a model or clinical situation to be clinically useful three requirements should be met. Firstly, asymptomatic embolisation should be frequent, providing sufficient power to evaluate therapies in relatively small numbers. Secondly, the situation should be clinically relevant. Thirdly in a particular clinical situation, the presence of asymptomatic embolisation should predict future transient ischemic attacks and stroke risks. A number of different potential models are discussed in this review and three promising areas are identified. These are monitoring for middle cerebral artery embolic signals during the immediate post-operative period in patients undergoing carotid endarterectomy and carotid angioplasty, and monitoring in patients with symptomatic carotid stenosis in a non-operative situation. The post endarterectomy situation has been studied the most, and has been successfully used to demonstrate the effectiveness of both a novel nitric oxide donor, S-nitrosoglutathione, and dextran. The high frequency of asymptomatic embolic signals in this situation has enabled drug efficacy to be demonstrated in small numbers of patients. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。