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J Thromb Thrombolysis. 2008 Apr;25(2):219-23. Epub 2007 May 20.

Microbubble potentiated transcranial duplex ultrasound enhances IV thrombolysis in acute stroke.

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Department of Neurology, Neurosonology Unit, HUG, University Hospital and Medical School of Geneva, Micheli-du-Crest 24, 1211 Geneva 14, Switzerland.



We studied whether 2 MHz transcranial color-coded duplex ultrasound (TCCD), combined with a second generation ECA, accelerate IV rtPA-thrombolysis in the acute phase of MCA stroke more than TCCD monitoring alone.


Non-randomized acute MCA stroke patients undergoing IV rtPA-thrombolysis and 2 MHZ-TCCD monitoring over 60 min, with (N = 11) or without (N = 15) additional continuous ECA (5 ml, SonoVue perfusion, were compared. Recanalization of the MCA was measured pre- and post-thrombolysis with the thrombolysis in brain ischemia (TIBI) grading system, clinical outcome was assessed at admission and 24 h after treatment using the NIH stroke scale (NIHSS).


Patients who received ECA improved their NIHSS significantly more than those who were only TCCD monitored (Mann-Whitney U = 48.0; P = 0.050), and their flow signal improved more (Mann-Whitney U = 40.0; P < 0.03).


The results of this pilot study show that in IV-thrombolysis the use of ECA in addition to TCCD monitoring lead to a greater immediate clinical improvement and to a better flow signal.

[Indexed for MEDLINE]

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