Auboire Laurent, Sennoga Charles A, Hyvelin Jean-Marc, Ossant Fréderic, Escoffre Jean-Michel, Tranquart François, Bouakaz Ayache
UMR Imagerie et Cerveau, Inserm U930, Université François-Rabelais de Tours, France.
CHRU de Tours, Service d'échographie-Doppler, Tours, France.
PLoS One. 2018 Feb 8;13(2):e0191788. doi: 10.1371/journal.pone.0191788. eCollection 2018.
Microbubbles (MBs) combined with ultrasound sonothrombolysis (STL) appears to be an alternative therapeutic strategy for acute ischemic stroke (IS), but clinical results remain controversial.
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.
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.
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.
Quality assessment of the studies reviewed revealed a number of biases.
Further in vivo studies are needed to demonstrate a better efficacy and safety of STL compared to currently approved therapeutic options.
微泡（MBs）联合超声溶栓（STL）似乎是急性缺血性卒中（IS）的一种替代治疗策略，但临床结果仍存在争议。
本系统评价的目的是确定所测试的参数；评估关于STL临床前数据安全性和有效性的证据；并评估其有效性和发表偏倚。
从1995年1月至2017年4月，对Pubmed®和Web of ScienceTM数据库进行系统检索，检索语言为法语和英语。我们纳入了评估动物卒中模型STL的研究。本系统评价按照PRISMA指南进行。由两位作者按照预先定义的方案提取数据。采用CAMARADES标准进行质量评估。进行了叙述性综合分析。
16项研究符合纳入标准。结果表明，各研究之间超声参数和微泡类型存在异质性。发现了许多关于疗效的阳性结果，但只有4项研究在临床标准上证明了STL优于重组组织型纤溶酶原激活剂。关于安全性的现有数据有限。
对所审查研究的质量评估揭示了一些偏倚。
需要进一步的体内研究来证明与目前批准的治疗方案相比，STL具有更好的疗效和安全性。
