Table 1.
Case series of sonothrombolysis for acute ischemic stroke.
| Author | Alexandrov AV, et al. [66] | Cintas, et al. [67] |
Alexandrov AV, et al. [68] |
Brunser A, et al. [69] |
Gu T, et al. [70] |
Aaron S, et al. [71] |
|---|---|---|---|---|---|---|
| Year of publication | 2000 | 2002 | 2004 | 2014 | 2015 | 2017 |
| Number of patients | 40 | 6 | 55 | 61 | 20 | 14 |
| Age (yr) | Mean 70 ± 16 | Mean 54.3 ± 14.7 | Mean 69 ± 15 | Mean 66 ± 18 | Median 71 (IQR 63–82) |
Mean 55 (range 32–76) |
| Time window (min) | Mean 125 ± 52 | Mean 210 ± 86 | Mean 125 ± 36 | Mean 127 | Median 98 (IQR 67–131) |
Mean 138 (Range 65–256) |
| Stroke type | ‘Occluded vessels’ (MCA. ICA, BA) |
MCA occlusion | ‘Proximal arterial occlusion’ | MCA occlusion | ‘Flow obstruction’ | LA-AIS |
| Technique | TCD | TCCD | TCD | TCD | TCD | TCD |
| Frequency (MHz) | 2 | 2 | 2 | 2 | 2 | 2 |
| Concomitant thrombolysis | Yes | No | Yes | Yes | Yes | Yes |
| Comparator | Nil | Nil | Nil | Nil | Nil | Nil |
| Outcome | Recanalization found at 45 ± 20 min—complete in 30%, partial in 40%. Dramatic recovery (total NIHSS score < 3)—20%)—all had complete recanalization. Improvement by ≥10 NIHSS points or complete recovery—30% at the end of tPA infusion, 40% at 24 h Improvement by ≥4 NIHSS points—62.5% at 24 h 3-month mortality—20% |
Partial recanalization (blunted waveforms)—83%. Mean time to beginning of recanalization 17.2 ± 9.6 min. Complete recanalization at 24 h—16.6% Mean NIHSS score in patients who recanalized during monitoring—21.2 ± 4.1 at baseline, 19.2 ± 5 at 2 h, and 15.6 ± 3.4 at 24 h |
Complete recanalization within 2 h 36%. Dramatic recovery (NIHSS score ≤ 3)—20% at 2 h, 24% at 24 h. Improvement by ≥4 NIHSS points—49% at 24 h |
Complete recanalization—44.3%. Modified Rankin Scale of 0–2 at 3 months—60% Case fatality—9.8% |
Full recanalization—29% Full or partial recanalization—36% 3-month follow-up—76% ADL independent |
TIBI residual flow grade of ≥2—83%. Immediate dramatic improvement (NIHSS score ≤ 3 points or improvement by ≥10 points)—30%; within the next 24 h—50%. At 6 months—mortality 11%, mRS ≤ 2 63% |
| Adverse events | Symptomatic intracerebral hemorrhage—7.5% | No hemorrhage | Symptomatic hemorrhage—5.5% | Asymptomatic intracranial hemorrhage—9.8% | No symptomatic intracranial bleeding | Symptomatic hemorrhage—5.5% |