Ultrasound reduces the risk of stroke during carotid artery surgery, confirms an international study conducted by doctors from the University of Ostrava
Carotid artery surgery, which reduces the risk of stroke in patients with atherosclerosis, can be accompanied by complications in the form of blood clots. An international study published in the British Medical Journal (BMJ), one of the most prestigious medical journals, demonstrates the effectiveness and safety of ultrasound in preventing these complications. The authors from the Faculty of Medicine of the University of Ostrava, the First Faculty of Medicine of Charles University, and the Military University Hospital Prague expect the study to have a significant impact on clinical practice in our country and abroad.
Stroke is the third most common cause of death worldwide. A large proportion of these deaths is caused by atherosclerosis, which leads to the narrowing of the arteries. "The operation, technically called carotid endarterectomy, reopens the carotid artery, thus ensuring sufficient flow of oxygenated blood to the brain. In the Czech Republic, neurosurgeons perform approximately 600 carotid endarterectomies per year, making the procedure one of the most common vascular surgeries," explains Prof. David Netuka, co-author of the study and Head of the Department of Neurosurgery and Neurooncology at the 1st Faculty of Medicine and the Military University Hospital Prague.
However, during the procedure, there is a risk of developing a complication in the form of cerebral ischemia in three to six percent of cases. During the procedure, a blood clot or a small fragment of an atherosclerotic plaque may dislodge and enter the cerebral arteries from the carotid artery. Cerebral ischemia may be transient and asymptomatic, but it can also lead to a stroke and permanent neurological consequences.
The possibilities for preventing these complications have recently been expanded with the addition of a new effective tool – sonolysis, which works on the principle of ultrasound. Its effects are explained by the lead author of the study, Prof. David Školoudík from the Atherosclerosis Research Working Group, Centre of Health Research, Department of Clinical Neurosciences, Faculty of Medicine, University of Ostrava: “Ultrasonic waves targeted at cerebral arteries lead to the activation of enzymes that are capable of dissolving blood clots formed during surgery. At the same time, sonolysis directly destroys blood clots with mechanical vibrations. In addition, prolonged exposure of the cerebral artery to ultrasound waves leads to the leaching of substances from the vascular wall that can dilate small cerebral arteries, thereby improving secondary blood flow to the affected area.”
A study of more than 1,000 patients, conducted at 16 sites across Europe, demonstrated the effectiveness and safety of the new method. "A very positive result was the confirmation that sonolysis reduced the risk of stroke by more than 70 percent, the risk of transient ischemic attack or 'mini stroke', as well as silent ischemic infarctions. Moreover, the treatment appears to be safe and does not lead to an increased risk of bleeding or other complications," explains Prof. Školoudík.
According to Prof. David Netuka, these new findings will soon make sonolysis standard in neurosurgical departments in the Czech Republic, and he expects rapid expansion in Slovakia and Austria as well. "Now we need to promote the results of the study and support the introduction of sonolysis throughout Europe and beyond," adds the neurosurgeon.
The international, purely academic study was created as part of the SONOBRIDE MR Trail project with financial support from a grant from the Agency for Health Research of the Czech Republic.
Updated: 11. 02. 2026
