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Updated: May 21, 2026

Prehospital Thrombolysis: A Manual from Berlin

Prehospital Thrombolysis: A Manual from Berlin

Published on: November 26, 2013

Sonothrombolysis for acute ischaemic stroke.

Stefano Ricci¹, Lavinia Dinia, Massimo Del Sette

¹UO Neurologia, ASL 1 dell’ Umbria, Città di Castello, Italy. istitaly@unipg.it.

The Cochrane Database of Systematic Reviews

|June 15, 2012

Summary

Sonothrombolysis for acute ischemic stroke did not reduce death or dependency at three months. However, it improved recanalization rates without increasing harm, suggesting potential benefits warranting further research.

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The Stroke Preclinical Assessment Network Multi-Laboratory Model of Thromboembolic Stroke with Thrombolysis: TE-MCAo

The Stroke Preclinical Assessment Network Multi-Laboratory Model of Thromboembolic Stroke with Thrombolysis: TE-MCAo

Published on: December 19, 2025

Area of Science:

Neurology
Interventional Neurology
Stroke Medicine

Background:

Sonothrombolysis is an emerging treatment for acute ischemic stroke, but its effectiveness and safety remain under investigation.
Debate continues regarding ultrasound administration techniques, microbubble use, and overall clinical impact.

Purpose of the Study:

To evaluate the efficacy and safety of sonothrombolysis in patients experiencing acute ischemic stroke.
To synthesize evidence from randomized controlled trials comparing sonothrombolysis with conventional treatments.

Main Methods:

A systematic review and meta-analysis of randomized controlled trials was conducted.
Searches included major databases (Cochrane, MEDLINE, EMBASE) up to November 2011.
Included trials involved sonothrombolysis initiated within 12 hours of symptom onset, with or without microbubbles, compared to intravenous tissue plasminogen activator (tPA) or standard care.

Main Results:

Five trials with 233 patients were analyzed.
Sonothrombolysis did not significantly alter death or dependency rates at three months (OR 0.80, 95% CI 0.45 to 1.44).
Recanalization rates were significantly improved with sonothrombolysis (OR 0.28, 95% CI 0.16 to 0.50), with no significant increase in mortality or cerebral hemorrhage.

Conclusions:

Sonothrombolysis does not reduce death or dependency in acute ischemic stroke patients at three months.
The treatment appears to enhance recanalization without evident safety concerns.
A larger clinical trial is recommended to further validate these findings and explore the potential of sonothrombolysis.