Microbubble potentiated transcranial duplex ultrasound enhances IV thrombolysis in acute stroke

J Thromb Thrombolysis. 2008 Apr;25(2):219-23. doi: 10.1007/s11239-007-0044-6. Epub 2007 May 20.


Background: 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.

Methods: 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).

Results: 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).

Conclusions: 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.

Publication types

  • Clinical Trial

MeSH terms

  • Aged
  • Female
  • Humans
  • Infarction, Middle Cerebral Artery / diagnostic imaging
  • Infarction, Middle Cerebral Artery / drug therapy*
  • Male
  • Microbubbles*
  • Phospholipids* / therapeutic use
  • Sulfur Hexafluoride* / therapeutic use
  • Thrombolytic Therapy*
  • Tissue Plasminogen Activator / therapeutic use*
  • Ultrasonography, Doppler, Color


  • Phospholipids
  • contrast agent BR1
  • Tissue Plasminogen Activator
  • Sulfur Hexafluoride