{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T20:40:53Z","timestamp":1789677653378,"version":"4.0.1"},"reference-count":24,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Stroke"],"published-print":{"date-parts":[[2008,5]]},"abstract":"<jats:p>\n            <jats:bold>\n              <jats:italic>Background and Purpose\u2014<\/jats:italic>\n            <\/jats:bold>\n            Sonothrombolysis is a new treatment approach in acute ischemic stroke. The results of a monocenter, randomized clinical study are presented.\n          <\/jats:p>\n          <jats:p>\n            <jats:bold>\n              <jats:italic>Methods\u2014<\/jats:italic>\n            <\/jats:bold>\n            Subjects with acute middle cerebral artery main stem occlusion were randomized into a target group receiving 1-hour transcranial continuous insonation using a 1.8-MHz Doppler ultrasound (US) probe or a control group. All underwent standard thrombolysis with intravenous recombinant tissue-type plasminogen activator.\n          <\/jats:p>\n          <jats:p>\n            <jats:bold>\n              <jats:italic>Results\u2014<\/jats:italic>\n            <\/jats:bold>\n            Thirty-seven subjects were included; 19 subjects were treated in the target (US) group and 18 in the control (no-US) group, all with no residual flow in the middle cerebral artery main stem occlusion (Thrombolysis in Brain Ischemia recanalization grade 0). Compared with the no-US group, the US group showed greater improvement in National Institutes of Health Stroke Scale values at days 1 and 4 and a higher median Thrombolysis in Brain Ischemia grade 1 hour after recombinant tissue-type plasminogen activator initiation. Recanalization (complete or partial) after 1 hour occurred in 57.9% of the US group and 22.2% of the no-US group (\n            <jats:italic>P<\/jats:italic>\n            =0.045). After 90 days, 4 subjects from the US group had a modified Rankin Score \u22641 (none from the no-US group) and 8 had a Barthel Index \u226595 (none from the no US group;\n            <jats:italic>P<\/jats:italic>\n            =0.106 and\n            <jats:italic>P<\/jats:italic>\n            =0.003, respectively). Three subjects from the US group (15.8%) developed a symptomatic intracranial hemorrhage as did one (5.6%) in the no-US group (\n            <jats:italic>P<\/jats:italic>\n            =0.60).\n          <\/jats:p>\n          <jats:p>\n            <jats:bold>\n              <jats:italic>Conclusions\u2014<\/jats:italic>\n            <\/jats:bold>\n            This small randomized study indicates a beneficial impact of transcranial ultrasound on recanalization and short-term outcome in subjects with middle cerebral artery main stem occlusion and recombinant tissue-type plasminogen activator treatment.\n          <\/jats:p>","DOI":"10.1161\/strokeaha.107.503870","type":"journal-article","created":{"date-parts":[[2008,3,15]],"date-time":"2008-03-15T00:13:09Z","timestamp":1205539989000},"page":"1470-1475","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":119,"title":["Sonothrombolysis With Transcranial Color-Coded Sonography and Recombinant Tissue-Type Plasminogen Activator in Acute Middle  Cerebral Artery Main Stem Occlusion"],"prefix":"10.1161","volume":"39","author":[{"given":"Ju\u0308rgen","family":"Eggers","sequence":"first","affiliation":[{"name":"From the Department of Neurology (J.E.), Asklepios Hospital Hamburg North, Hamburg, Germany; the Departments of Neurology (G.S.) and Neuroradiology (G.H.) and the Institute of Medical Biometry and Statistics (I.R.K.), University Hospital of Schleswig-Holstein, Campus Lu\u0308beck, Lu\u0308beck, Germany; and the Department of Neurology (B.K.), Aschaffenburg Hospital, Aschaffenburg, Germany."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Inke R.","family":"Ko\u0308nig","sequence":"additional","affiliation":[{"name":"From the Department of Neurology (J.E.), Asklepios Hospital Hamburg North, Hamburg, Germany; the Departments of Neurology (G.S.) and Neuroradiology (G.H.) and the Institute of Medical Biometry and Statistics (I.R.K.), University Hospital of Schleswig-Holstein, Campus Lu\u0308beck, Lu\u0308beck, Germany; and the Department of Neurology (B.K.), Aschaffenburg Hospital, Aschaffenburg, Germany."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bjo\u0308rn","family":"Koch","sequence":"additional","affiliation":[{"name":"From the Department of Neurology (J.E.), Asklepios Hospital Hamburg North, Hamburg, Germany; the Departments of Neurology (G.S.) and Neuroradiology (G.H.) and the Institute of Medical Biometry and Statistics (I.R.K.), University Hospital of Schleswig-Holstein, Campus Lu\u0308beck, Lu\u0308beck, Germany; and the Department of Neurology (B.K.), Aschaffenburg Hospital, Aschaffenburg, Germany."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Go\u0308tz","family":"Ha\u0308ndler","sequence":"additional","affiliation":[{"name":"From the Department of Neurology (J.E.), Asklepios Hospital Hamburg North, Hamburg, Germany; the Departments of Neurology (G.S.) and Neuroradiology (G.H.) and the Institute of Medical Biometry and Statistics (I.R.K.), University Hospital of Schleswig-Holstein, Campus Lu\u0308beck, Lu\u0308beck, Germany; and the Department of Neurology (B.K.), Aschaffenburg Hospital, Aschaffenburg, Germany."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gu\u0308nter","family":"Seidel","sequence":"additional","affiliation":[{"name":"From the Department of Neurology (J.E.), Asklepios Hospital Hamburg North, Hamburg, Germany; the Departments of Neurology (G.S.) and Neuroradiology (G.H.) and the Institute of Medical Biometry and Statistics (I.R.K.), University Hospital of Schleswig-Holstein, Campus Lu\u0308beck, Lu\u0308beck, Germany; and the Department of Neurology (B.K.), Aschaffenburg Hospital, Aschaffenburg, Germany."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_1_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(03)00380-6"},{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0929-8266(02)00049-6"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0301-5629(01)00481-1"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0301-5629(00)00211-8"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0301-5629(98)00158-6"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa041175"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.str.0000199064.94588.39"},{"key":"e_1_3_2_8_2","doi-asserted-by":"crossref","unstructured":"Perren F Loulidi J Poglia D Landis T Sztajzel R. 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