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Hemostasis is a crucial process that prevents excessive blood loss from damaged blood vessels. It involves various mechanisms such as vasoconstriction, platelet adhesion and activation, and fibrin formation. The importance of each mechanism depends on the type of vessel injury. In contrast, thrombosis is the abnormal formation of a blood clot within the blood vessels, leading to potential complications if the clot obstructs blood flow. Thrombosis can be caused by increased coagulability of the...
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Related Experiment Video

Updated: Jun 29, 2025

Prehospital Thrombolysis: A Manual from Berlin
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Sonothrombolysis for Ischemic Stroke.

Narayanaswamy Venketasubramanian1, Leonard L L Yeo2, Benjamin Tan2

  • 1Raffles Neuroscience Centre, Raffles Hospital Singapore, Singapore 188770, Singapore.

Journal of Cardiovascular Development and Disease
|March 27, 2024
PubMed
Summary

Ultrasound shows promise in enhancing clot lysis for acute ischemic stroke (IS) treatment. However, clinical trials have not yet demonstrated improved functional independence, requiring further research for routine use.

Keywords:
ischemic strokesonothrombolysisthrombolysisultrasound

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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.