Pro- and antifibrinolytic effects of ultrasound on streptokinase-induced thrombolysis.

We have earlier documented that ultrasound can enhance the fibrinolytic effect of streptokinase and shorten the reperfusion time under experimental conditions. The present study concerns the magnitude of the effect in relation to ultrasound frequency, intensity and exposure time. The effect of ultrasound on the structural properties of the fibrin network was evaluated by scanning electron microscopy. Whole blood clots were created and exposed to streptokinase (5000 U/mL). In paired experiments, one clot was also exposed to pulsed ultrasound. Lysis is expressed as the percentage decrease in clot weight. Clot lysis was equally affected by ultrasound in the range of 0.5 to 2.3 MHz. Below 0.5 W/cm2 no enhancing effect was observed, while intensities between 0.5 and 1.5 W/cm2 resulted in a significant enhancement of clot lysis. Intensities above 4 W/cm2 inhibited the fibrinolytic effect of streptokinase but not of rt-PA. From scanning electron microscopy there was no evidence that ultrasound disrupted the clot surface or damaged the fibrin structure.