Stroke Trials CLOTBUST

Ultrasound enhanced thrombolysis-- u/s can help diagnose clot, monitor thrombolysis and increase t-Pa binding to thrombin. CLOTBUST-- combined lysis of thrombus in brain ischemia using transcranial ultrasound and systemic rt-PA. 2001-4 Texas-Houston, 126 patients enrolled. All patients received alteplase within guidelines and half got TCD monitoring, the other half placebo monitoring. Half (49 %) of treatment group reached endpoint of complete recanalization or dramatic clinical recovery (NIHSS of 3 or less) within 2 hours, compared to 30 % of controls. At 3 months 42-29 % favoring treatment had mRankins of 0 or 1. Three subjects in each group had ICH. Authors concluded that arterial recanalization was augmented by TCD.