Changes in haemocoagulation in healthy volunteers after a 1-hour thrombotripsy using a diagnostic 2–4 MHz transcranial probe

Abstract

Thrombotripsy with 1-hour TCD monitoring using a 2-4 MHz diagnostic probe may affect the fibrinolytic system in humans.

Sonolysis in prevention of brain infarction during cardiac surgery (Sonorescue): a randomized, controlled trial

“…29 Results of the present study also support the safety and efficacy of sonolysis for prevention of periprocedural brain ischemic lesions in patients undergoing Unlike studies using sonolysis in acute stroke patients, not a direct effect of ultrasound waves on the clot but mainly an activation of fibrinolytic system was used in the SONOBUS-TER Trial and in the presented SONORESCUE Trial. 29,30 Published studies have demonstrated the effect of sonolysis on acceleration of arterial recanalization when combined with intravenous thrombolysis in patients with acute stroke. 9,15,16 Moreover, recent studies have also shown the effect of sonolysis on activation of endogenous fibrinolytic enzymes in healthy volunteers 30 and acute-stroke patients without application of thrombolytic agents.…”

“…29,30 Published studies have demonstrated the effect of sonolysis on acceleration of arterial recanalization when combined with intravenous thrombolysis in patients with acute stroke. 9,15,16 Moreover, recent studies have also shown the effect of sonolysis on activation of endogenous fibrinolytic enzymes in healthy volunteers 30 and acute-stroke patients without application of thrombolytic agents. 9,17,18 The mechanisms responsible for a reduced prevalence and volume of lesions after sonolysis in the present study could include acceleration of enzymatic fibrinolysis by the direct activation of a fibrinolytic system and increased transport of fibrinolytic agents (eg, plasmin) into the thrombus by mechanical disruption of thrombus structure, destruction of gaseous bubbles, and transient peripheral vasodilatation.…”

Safety and efficacy of sonothrombolysis using bilateral TCD monitoring by diagnostic 2 MHz probes - a pilot study

“…1,2,4,6,14,[20][21][22][23] ), the effect of TCD monitoring in acute IS patients was reported for the first time in 2000 (ref. 24 ) and the results of the first randomized study, testing the effect of sonothrombolysis showed the safety and efficacy of sonothrombolysis using the diagnostic 2-MHz TCD probe 7 .…”

“…Firstly, mechanical effect caused by the thrombus vibration may lead to the acceleration of the penetration of fibrinolytics 3 . Secondly, non-thermal mechanisms -increasing the transport of fibrinolytic agents into the thrombus by mechanical disruption of its structure 24 , direct activation of fibrinolytic enzymes 14,15 , transient peripheral vasodilatation caused probably by increased production of nitrite oxide in the endothelium 21,26 also play a role in clot dissolution. However, confirmation of different effects on thrombus dissolution using various ultrasound frequencies and intensities are still missing.…”

“…In vitro and in vivo studies on animal models as well as on IS patients with volunteers proved that ultrasound with low frequencies and high intensity has a primarily mechanical effect, quickly destroying the thrombus into microscopic fragments, whereas using high frequencies (around 2 MHz) causes activation of the endogenic fibrinolytic system 3,14,15 . The aim of this pilot study was to assess if local increase of ultrasound intensity (spacial peak temporal average, SPTA) in the area of the occluded MCA using 2 diagnostic transcranial Doppler probes with 2-MHz frequency during bilateral monitoring increases the percentage of MCA recanalizations and improves the clinical outcome of IS patients with occlusion of the MCA arterial trunk or branch.…”