title: Effect of externally applied focused acoustic energy on clot disruption in vitro.
abstract: Application of low-frequency ultrasound for clot disruption has been suggested as a potential therapy to enhance thrombus dissolution, but the optimal mode for delivery of ultrasound with clot-disruptive properties has not yet been extensively explored. Target-specific effects are desirable and may be accomplished by focusing the ultrasound. Adequate focusing, however, requires a short wavelength. The aim of this study was to compare the clot-disruptive effects of different modalities of focused acoustic energy. An in vitro model (10 blood clots for each modality) was used to test the clot-disruptive capacity of (i) shock waves generated in an electrohydraulic lithotriptor; (ii) focused continuous ultrasound of frequency 1.1 MHz, delivered from a specially constructed piezoelectric transducer; and (iii) focused pulse-modulated ultrasound of frequency 1.1 MHz delivered from the same transducer. Exposure to 30 s of focused pulse-modulated ultrasound caused a marked reduction (99+/-2%) in clot weight compared with 30 shock waves (11+/-5%) or 30 s exposure to focused continuous wave ultrasound (11+/-6%) (P<0.0001). The observed marked and rapid disruptive effect on blood clots of focused high-frequency ultrasound indicates an alternative approach for external ultrasound-mediated thrombus destruction in vivo. The focused pulse-modulated technique has potential to exhibit the desired effect in a well-defined target volume and provides the means for control of the average power.
authors.affiliation: Department of Medical Laboratory Science and Technology, Karolinska Institute, Huddinge University Hospital, 141 86 Huddinge, Stockholm, Sweden.
authors.forename: S
authors.initials: S
authors.lastname: Westermark
authors.forename: H
authors.initials: H
authors.lastname: Wiksell
authors.forename: H
authors.initials: H
authors.lastname: Elmqvist
authors.forename: K
authors.initials: K
authors.lastname: Hultenby
authors.forename: H
authors.initials: H
authors.lastname: Berglund
mesh_terms: D006801:Humans; D013927:Thrombosis / Q000628:therapy*; D013997:Time Factors; D014464:Ultrasonic Therapy / Q000379:methods*