Transcranial Ultrasound Used As an Adjunct to tPA Fails To Improve Functionality in Ischemic Stroke Patients Sonothrombolysis with ultrasound delivered transcranially via a headframe shows no clinical benefit in ischemic stroke

A randomized, mutilcenter, placebo-controlled, phase 3 clinical trial which enrolled 676 patients (aged 18-80 years) presenting to the ER with acute ischemic stroke assessed  the efficacy and safety of transcranial ultrasound (US) as an adjunctive therapy to intravenous tissue plasminogen activator (IV-tPA, administered over 60 minutes) treatment (CLOTBUST-ER trial). The results from the trial, which was stopped due to futility show that although the use of sonothrombolysis was feasible and most likely safe, no clinical benefit was seen at 90 days. Compared with the control group, the adjusted cOR for an improvement in modified Rankin Scale score (mRSC) at 90 days in the intervention group was 1.05 (95% CI 0.77–1.45; p=0.74). Andrei Alexandrov, MD (University of Tennessee Health Science Center, Memphis), and colleagues reported in the April 2019 issue of the Lancet Neurology. Continue reading