One treatment challenge for cerebral venous sinus thrombosis (CVST) is to achieve recanalization within a short period of time (e.g., 30 min) for significant clinical outcomes. Ultrasound-mediated thrombolysis (sonothrombolysis) presents a promising treatment for venous embolism. In this paper, a miniature vortex ultrasound transducer with frequency of 1.8 MHz was developed for sonothrombolysis. A composite transducer with 2-by-2 sub-aperture piezoelectric elements was assembled into a 9-French catheter to generate a physical helical wavefront. The prototyped vortex ultrasound catheter was characterized by measuring the acoustic pressure amplitude and phases, followed by in-vitro- sonothrombolysis tests. It was found that a vortex ultrasound field can be successfully generated by the prototype. The vortex lytic rate was increased by more than 50% compared with the nonvortex lysis with the same acoustic power input. A long (∼7.5 cm), completely occluded in-vitro- 3D model of acute CVST was fully recanalized within 8 min. The unprecedented sonothrombolysis rate was likely attributed to the vortex ultrasound-induced shear stress, which can effectively disrupt acute blood clots. Furthermore, no vessel wall damage over ex-vivo bovine veins was found after the vortex sonothrombolysis treatment.