Friday, 19. August 2022

Individualised medicine: Pilot study on therapy for ischaemic strokes

In a pilot study, senior physician Dr. Tinchon from the Karl Landsteiner University and colleagues investigated the use of rotational thromboelastomery for outcome evaluation after thrombolytic therapy in patients suffering from acute ischemic stroke.

Rotational thromboelastomery measures whole blood coagulation in vitro.Alteplase, a tissue plasminogen activator, is administered as systemic standard treatment for ischemic stroke. Patients respond differently to this drug therapy: while some patients fully recover, others show little or no benefit. Rotational thromboelastomy measures whole blood coagulation by recording the movements of a pin in a test cup with the patient´s blood sample. The flow and clotting properties of the blood can be investigated. 12 patients with ischemic stroke examined12 patients of the University Hospital St. Pölten with a confirmed acute ischemic stroke received the drug Alteplase as standard medical treatment. The clinical outcome was assessed with a standardised diagnostic tool (National Institutes of Health Stroke Scale, NIHSS). Venuos blood samples were taken before and during the treatment with Alteplase. Using rotational thromboelastomery, whole blood coagulation of these samples in vitro was analysed in 144 individual measurements at different times during intravenous thrombolysis. Low-responders and high-responders detectableThe curve profiles of the rotational thromboelastomery correlated with the treatment success. Patients with a strong in vitro reaction had a better clinical outcome than those with a weeker fibrinolytic response. Potential for use in clinical practiceThe study suggests, that rotational thromboelastomery could be used for individualised fibrinolytic therapy in ischemic stroke patients in the future. The work is freely accessible within the framework of KL's open access agreement with the publisher Springer. The research work of OA Dr. Tinchon is promoted and supported by a research time out within the initiative "Go! Research". Originalpublication:Tinchon A, Freydl E, Fitzgerald RD, Duarte C, Weber M, Calabek-Wohinz B, et al. Real-time monitoring of intravenous thrombolysis in acute ischemic stroke using rotational thromboelastometry: a feasibility pilot study. J Neurol. 2022.

Individualised medicine: Pilot study on therapy for ischaemic strokes

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