title: Safety and efficacy of sonothrombolysis using bilateral TCD monitoring by diagnostic 2 MHz probes - a pilot study.
abstract: BACKGROUND
  Sonothrombolysis is a new treatment method for patients with acute ischemic stroke (IS). Various ultrasound frequencies and intensities are being tested these days. The aim of this pilot study was to assess the safety and efficacy of sonothrombolysis using 2 diagnostic probes and bilateral monitoring in patients with acute occlusion of the middle cerebral artery (MCA).
  
  
  METHODS
  Twelve consecutive IS patients (7 males; age 47 - 78, average 64.1 ± 9.4 years) with acute MCA occlusion and contraindication of thrombolysis were included in the study. 60-min bilateral 2-MHz pulsed-wave Doppler monitoring of the area of occlusion was performed in all patients (Group 1). The control group consisted of 37 IS patients (20 males; age 32 - 78, average 62.2 ± 12.1 years) treated with standard sonothrombolysis and selected from the Thrombotripsy Study database (Group 2). The differences in number of recanalized arteries after a 1 h treatment, independent patients (modified Rankin scale [mRS] value of 0 - 2) after 90 days and symptomatic intracerebral hemorrhages (SICH) were statistically evaluated.
  
  
  RESULTS
  Complete recanalization was found in 4 (30.0%) Group 1 and in 12 (32.4%) Group 2 patients. Seven (58.3%) Group 1 and 22 (59.5%) Group 2 patients were independent after 90 days. SICH was found in none of Group 1 patients and in 1 (2.7%) of the Group 2 patients (P>0.05 in all cases).
  
  
  CONCLUSIONS
  In this pilot study, sonothrombolysis using 2 probes and bilateral monitoring is safe but not more effective than standard sonothrombolysis in acute IS patients with MCA occlusion.
authors.affiliation: Department of Neurology, Hospital Trinec-Sosna, Trinec, Czech Republic.
authors.forename: Petr
authors.initials: P
authors.lastname: Bardon
authors.forename: Martin
authors.initials: M
authors.lastname: Kuliha
authors.forename: Roman
authors.initials: R
authors.lastname: Herzig
authors.forename: Petr
authors.initials: P
authors.lastname: Kanovsky
authors.forename: David
authors.initials: D
authors.lastname: Skoloudik
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D006495:Heparin, Low-Molecular-Weight / Q000627:therapeutic use; D006801:Humans; D020244:Infarction, Middle Cerebral Artery / Q000000981:diagnostic imaging* / Q000628:therapy*; D008297:Male; D061185:Mechanical Thrombolysis / Q000009:adverse effects / Q000379:methods; D008875:Middle Aged; D010865:Pilot Projects; D014464:Ultrasonic Therapy / Q000009:adverse effects; D017585:Ultrasonography, Doppler, Transcranial
chemical_list: D005343:Fibrinolytic Agents; D006495:Heparin, Low-Molecular-Weight