title: Liver hemostasis using high-intensity focused ultrasound.
abstract: Liver hemorrhage, the major cause of death in hepatic trauma, is notoriously difficult to control. We report on the use of high-intensity focused ultrasound (HIFU) to arrest the bleeding from incisions made in rabbit livers. A HIFU transducer, with a spherically curved aperture of 6.34 cm2 area, a focal length of 4 cm and a frequency of 3.3 MHz was used. In approximately 94% of the incisions, the hemorrhage was reduced to a slow oozing of blood in less than 2 min. The maximum temperature of liver tissue around the incision area, during HIFU application, was measured to be 86 degrees C. The mechanism of hemostasis, confirmed by histological examination, appears to be coagulative necrosis of a volume of liver tissue around the incision. We believe that acoustic hemostasis, with the unique characteristic of "volume cauterization," offers a novel method for the management of liver hemorrhage and, thus, has major clinical implications.
authors.affiliation: Bioengineering Laboratory, University of Washington, Seattle 98195, USA.
authors.forename: S
authors.initials: S
authors.lastname: Vaezy
authors.forename: R
authors.initials: R
authors.lastname: Martin
authors.forename: U
authors.initials: U
authors.lastname: Schmiedl
authors.forename: M
authors.initials: M
authors.lastname: Caps
authors.forename: S
authors.initials: S
authors.lastname: Taylor
authors.forename: K
authors.initials: K
authors.lastname: Beach
authors.forename: S
authors.initials: S
authors.lastname: Carter
authors.forename: P
authors.initials: P
authors.lastname: Kaczkowski
authors.forename: G
authors.initials: G
authors.lastname: Keilman
authors.forename: S
authors.initials: S
authors.lastname: Helton
authors.forename: W
authors.initials: W
authors.lastname: Chandler
authors.forename: P
authors.initials: P
authors.lastname: Mourad
authors.forename: M
authors.initials: M
authors.lastname: Rice
authors.forename: R
authors.initials: R
authors.lastname: Roy
authors.forename: L
authors.initials: L
authors.lastname: Crum
mesh_terms: D000818:Animals; D001652:Bile Ducts / Q000473:pathology; D001831:Body Temperature; D004195:Disease Models, Animal; D006470:Hemorrhage / Q000473:pathology / Q000503:physiopathology / Q000628:therapy*; D006489:Hemostatic Techniques; D006499:Hepatic Artery / Q000473:pathology; D006503:Hepatic Veins / Q000473:pathology; D006358:Hot Temperature; D008099:Liver / Q000293:injuries; D008107:Liver Diseases / Q000473:pathology / Q000503:physiopathology / Q000628:therapy*; D009336:Necrosis; D011817:Rabbits; D016896:Treatment Outcome; D014464:Ultrasonic Therapy / Q000379:methods*