Sonothrombolysis for Ischemic Stroke.

Area of Science:

• Neurology
• Biomedical Engineering
• Medical Imaging

Background:

• Ischemic stroke (IS) is a leading cause of global mortality and disability.
• Current treatments like intravenous thrombolysis and endovascular thrombectomy have time-sensitive windows.
• Ultrasound demonstrates potential in enhancing thrombolysis and recanalization in preclinical models.

Purpose of the Study:

• To review the current evidence on sonothrombolysis for acute ischemic stroke.
• To evaluate the efficacy and safety of ultrasound-assisted thrombolysis.
• To explore emerging ultrasound-based technologies for stroke management.

Main Methods:

• Review of existing literature including case series, controlled studies, and clinical trials.
• Analysis of ultrasound parameters, specifically frequency (2 MHz vs. 300 kHz), and adjunctive agents like microbubbles.
• Examination of outcomes related to recanalization, intracranial hemorrhage, and functional independence.

Main Results:

• Ultrasound, particularly 2 MHz range, aids thrombolysis and recanalization without significantly increasing hemorrhage risk.
• Adjunctive use of microbubbles or microspheres did not improve functional independence in clinical trials.
• Despite positive preclinical data, clinical trials have not shown improved functional outcomes.

Conclusions:

• Sonothrombolysis shows potential for acute ischemic stroke management but requires more clinical evidence.
• Current clinical trials have not confirmed benefits in functional independence.
• Further research and newer technologies like endovascular ultrasound are needed before routine adoption.