Ultrasound imaging-guided noninvasive ultrasound thrombolysis - Preclinical results

Article

关键词: TISSUE-PLASMINOGEN ACTIVATOR;    ACUTE MYOCARDIAL-INFARCTION;    EXTERNAL ULTRASOUND;    THROMBUS ABLATION;    ENHANCEMENT;    THERAPY;    ANGIOPLASTY;    ARTERIES;    FIBRIN;    RECANALIZATION;   

DOI  :  10.1161/01.CIR.102.2.238

来源: SCIE

【 摘 要 】

Background-Catheter-based therapeutic ultrasound thrombolysis was recently shown to be effective and safe. The purpose of this work was to study the safety and efficacy of external high-intensity focused ultrasound thrombolysis guided by ultrasound imaging in experimental settings. Methods and Results-A therapeutic transducer was constructed from an acoustic lens and integrated with an ultrasound imaging transducer. In vitro clots were inserted into bovine arterial segments and sonicated under real-time ultrasound imaging guidance in a water tank. With pulsed-wave (PW) ultrasound, the total sonication time correlated with thrombolysis efficiency (r(2)=0.7666). A thrombolysis efficiency of 91% was achieved with optimal PW parameters (1:25 duty cycle, 200-mu s pulse length) at an intensity (I-spta) of >35+/-5 W/cm(2). Ultrasound imaging during sonication showed the cavitation field as a spherical cloud of echo-dense material. Within <2 minutes, the vessel lumen evidenced neither residual clot nor damage to the arterial wall. On serial filtration, 93+/-1% of the lysed clot became subcapillary in size (<8 mu m). In vitro safety studies, however, showed arterial damage when an I-spta of 45 W/cm(2) was used for periods of greater than or equal to 300 seconds. Conclusions-External high-intensity focused ultrasound thrombolysis using optimal PW parameters for periods of less than or equal to 300 seconds appears to be a safe and effective method to induce thrombolysis, The procedure can be guided by ultrasound imaging, thereby allowing the monitoring of therapy.

【 授权许可】

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