[1] One major advantage of using ultrasound versus systemic thrombolysis is a reduced risk of bleeding, and improved heart function in the case of pulmonary embolism.
[6] Transcranial Doppler ultrasound was first investigated in 2004, and demonstrated a significant clinical recovery through the use of sonothrombolysis with tPA, specifically through arterial recanalization.
A meta-analysis conducted in 2020 investigating the safety and efficacy of sonothromoblysis in 5 randomized controlled trials demonstrated that there was overall benefit to using sonothrombolysis especially in the setting of a middle cerebral artery occlusion.
In certain patients with more severe forms of PE (massive or submassive), sonothrombolysis can improve cardiopulmonary function and reduce the bleeding risk that is accompanied by systemic thrombolysis.
However, recent data does demonstrate that in patients with an ST-segment elevation myocardial infarction (STEMI), sonothrombolysis may improve flow within the impacted vessels allowing for better cardiac muscle oxygenation.