Dodecafluoropentane emulsion (DDFPe) nanodroplets are exceptional
oxygen transporters and can protect ischemic brain in
stroke models 24 h without reperfusion. Current
stroke therapy usually fails to reach patients because of delays following
stroke onset. We tested using DDFPe to extend the time window for
tissue plasminogen activator (tPA). Longer treatment windows will allow more patients more complete
stroke recovery. We test DDFPe to safely extend the time window for tPA thrombolysis to 9 h after
stroke. With IACUC approval, randomized New Zealand white rabbits (3.4-4.7 kg,
n = 30) received angiography and 4-mm
blood clot in the internal carotid artery for flow-directed
middle cerebral artery occlusion. Seven failed and were discarded. Groups were IV tPA (n = 11), DDFPe + tPA (n = 7), and no
therapy controls (n = 5). DDFPe (0.3 ml/kg, 2 %
emulsion) IV dosing began at 1 h and continued at 90 min intervals for 6 doses in one test group; the other received saline
injections. Both got standard IV tPA (0.9 mg/kg)
therapy starting 9 h post
stroke. At 24 h, neurological assessment scores (NAS, 0-18) were determined. Following brain removal percent stroke volume (%SV) was measured. Outcomes were compared with Kruskal-Wallis analysis. For
NAS, DDFPe + tPA was improved overall, p = 0.0015, and vs. tPA alone, p = 0.0052. For %SV, DDFPe + tPA was improved overall, p = 0.0003 and vs. tPA alone, p = 0.0018.
NAS controls and tPA alone were not different but %SV was, p = 0.0078. With delayed reperfusion, DDFPe + tPA was more effective than tPA alone in preserving functioning brain after
stroke. DDFPe significantly extends the time window for tPA
therapy.