Contrast Ultrasound, Sonothrombolysis and Sonoperfusion in Cardiovascular Disease: Shifting to Theragnostic Clinical Trials

Soufiane el Kadi, Thomas R. Porter, Niels J. W. Verouden, Albert C. van Rossum, Otto Kamp

Research output: Contribution to journalReview articleAcademicpeer-review

7 Citations (Scopus)


Contrast ultrasound has a variety of applications in cardiovascular medicine, both in diagnosing cardiovascular disease as well as providing prognostic information. Visualization of intravascular contrast microbubbles is based on acoustic cavitation, the characteristic oscillation that results in changes in the reflected ultrasound waves. At high power, this acoustic response generates sufficient shear that is capable of enhancing endothelium-dependent perfusion in atherothrombotic cardiovascular disease (sonoperfusion). The oscillation and collapse of microbubbles in response to ultrasound also induces microstreaming and jetting that can fragment thrombus (sonothrombolysis). Several preclinical studies have focused on identifying optimal diagnostic ultrasound settings and treatment regimens. Clinical trials have been performed in acute myocardial infarction, stroke, and peripheral arterial disease often with improved outcome. In the coming years, results of ongoing clinical trials along with innovation and improvements in sonothrombolysis and sonoperfusion will determine whether this theragnostic technique will become a valuable addition to reperfusion therapy.
Original languageEnglish
Pages (from-to)345-360
Number of pages16
JournalJACC. Cardiovascular imaging
Issue number2
Early online date7 Oct 2021
Publication statusPublished - 1 Feb 2022


  • cardiovascular
  • contrast ultrasound
  • sonoperfusion
  • sonothrombolysis
  • theragnostics

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