For sufferers present process carotid endarterectomy, sonolysis is protected and ends in a major discount within the composite incidence of ischemic stroke, transient ischemic assault, and loss of life inside 30 days, in response to a research printed on-line March 19 in The BMJ.
David Školoudík, Ph.D., from the College of Ostrava within the Czech Republic, and colleagues examined the effectiveness and security of sonolysis utilizing a low-intensity 2-MHz pulsed wave ultrasound beam throughout carotid endarterectomy in a part 3 trial involving 1,004 sufferers from 16 European facilities. Individuals had been randomly assigned to obtain sonolysis or sham process (507 and 497 people, respectively). The composite incidence of ischemic stroke, transient ischemic assault, and loss of life inside 30 days was the first finish level.
The researchers discovered that the outcomes favored sonolysis for the first finish level (2.2 versus 7.6%) and within the substudy for magnetic resonance imaging-detected new ischemic lesions (8.5 versus 17.4%). In a sensitivity evaluation, the danger ratios for sonolysis had been 0.25 and 0.23 for ischemic stroke and transient ischemic stroke, respectively, inside 30 days. Sonolysis was protected; 30 days after the process, 94.4% of sufferers had been free from critical hostile occasions.
“Sonolysis should be used to reduce the risk of periprocedural cerebrovascular events during carotid endarterectomy in all patients with sufficient temporal bone window for transcranial Doppler,” the authors write. “It has the potential to make carotid endarterectomy safer with a higher benefit for patients with carotid stenosis compared with the best medical treatment, especially in patients with asymptomatic carotid stenosis.”
Extra data:
Summary/Full Textual content: David Školoudík et al, Sonolysis throughout carotid endarterectomy: randomised managed trial, The BMJ (2025). DOI: 10.1136/bmj-2024-082750
Editorial: Jesse A. Columbo, Therapeutic ultrasound throughout carotid endarterectomy, The BMJ (2025). DOI: 10.1136/bmj.r385
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Sonolysis reduces threat for periprocedural cerebrovascular occasions throughout carotid endarterectomy (2025, March 20)
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