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Updated: Jul 17, 2026
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Functional Transcranial Doppler Ultrasound for Monitoring Cerebral Blood Flow
Published on: March 15, 2021
Acute stroke: therapeutic transcranial Doppler sonography
1Department of Neurology, University of Texas Health Science Center at Houston, Houston, Tex., USA.
Frontiers of Neurology and Neuroscience
|February 10, 2007
Summary
Low-intensity ultrasound (US) enhances tissue plasminogen activator (t-PA) for ischemic stroke. This noninvasive treatment improved recanalization and clinical recovery in patients with middle cerebral artery occlusion.
Area of Science:
- Neurology
- Biomedical Engineering
- Medical Imaging
Background:
- Ischemic stroke treatment traditionally involves thrombolysis.
- Ultrasound (US) offers a noninvasive, site-specific approach to enhance thrombolysis.
- Previous studies indicated potential risks with certain US frequencies.
Purpose of the Study:
- To evaluate the efficacy and safety of 2MHz transcranial sonothrombolysis combined with tissue plasminogen activator (t-PA) for acute ischemic stroke.
- To assess the impact of US on recanalization rates and clinical outcomes in middle cerebral artery (MCA) occlusions.
Main Methods:
- Phase II randomized clinical trial (CLOTBUST study).
- Patients with MCA occlusion within 3 hours of stroke onset received standard t-PA.
- One group was monitored with 2MHz US for MCA blood flow.
Main Results:
- The group treated with US and t-PA showed significantly increased rates of complete recanalization.
- Dramatic clinical recovery was significantly higher in the US plus t-PA group compared to t-PA alone.
- 2MHz US demonstrated promising results, unlike earlier mid-kHz frequency trials.
Conclusions:
- 2MHz transcranial sonothrombolysis is a safe and effective adjunct to t-PA for acute ischemic stroke.
- This US-based therapy enhances thrombolysis, improving blood flow restoration and patient outcomes.
- Further research may explore microbubble enhancement for sonothrombolysis.
