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Effects of batroxobin with continuous transcranial Doppler monitoring in patients with acute cerebral stroke: a randomized controlled trial.

Abstract
Our objective was to determine whether continuous transcranial Doppler (TCD) monitoring could safely enhance the efficacy of batroxobin, a thrombin-like enzyme extracted from Bothrops atrox moojeni venom, in the treatment for acute cerebral stroke beyond the thrombolytic time window. Ninety patients suffering an acute cerebral stroke were recruited into the study within 12 hours after the onset of symptoms. Patients were randomized to receive batroxobin with (target group) or without 1 hour of continuous TCD monitoring (control group). Clinical evaluation of stroke was based on the National Institutes of Health Stroke Scale (NIHSS) score, Barthel index (BI), Thrombolysis in Brain Ischemia score (TIBI), the incidence of advancing stroke, and the recurrence of cerebral infarction. The patients receiving continuous TCD monitoring showed significant improvement in NIHSS score at 57 days post treatment compared with the control. Similarly, patients receiving continuous TCD monitoring also showed significant improvement in BI at 3 months compared with the controls. Consistently, both the incidence of advancing stroke after 1 week and the incidence of stroke recurrence after 3 months were significantly lower in TCD monitored group than control group. Moreover, the safety of the employment of TCD monitoring in the treatment of these patients was confirmed as there was no significant difference of the incidence of intracranial hemorrhage at 1 week after the treatment between the target and control groups. Taken together, our study showed that batroxobin, in combination with continuous TCD monitoring at the middle cerebral artery, reduced the incidence of advancing stroke and stroke recurrence after treatment without adverse effects in terms of poststroke intracranial hemorrhage.
AuthorsHe Yitao, Ma Kefu, Tang Bingshan, Fu Xuejun, Zhan Ying, Cai Zhili, Jiang Xin, Yi Guo
JournalEchocardiography (Mount Kisco, N.Y.) (Echocardiography) Vol. 31 Issue 10 Pg. 1283-92 (Nov 2014) ISSN: 1540-8175 [Electronic] United States
PMID24684297 (Publication Type: Comparative Study, Journal Article, Randomized Controlled Trial)
Copyright© 2014, Wiley Periodicals, Inc.
Chemical References
  • Fibrinolytic Agents
  • Batroxobin
Topics
  • Adult
  • Aged
  • Batroxobin (administration & dosage)
  • Female
  • Fibrinolytic Agents (administration & dosage)
  • Humans
  • Infusions, Intravenous
  • Male
  • Middle Aged
  • Monitoring, Physiologic (methods)
  • Prognosis
  • Reference Values
  • Risk Assessment
  • Severity of Illness Index
  • Statistics, Nonparametric
  • Stroke (diagnostic imaging, drug therapy, mortality)
  • Survival Rate
  • Treatment Outcome
  • Ultrasonography, Doppler, Transcranial (methods)

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