Spleen hemostasis using high-intensity ultrasound: survival and healing.
BACKGROUND
Previous studies have shown that high-intensity focused ultrasound (HIFU) can effectively control bleeding of incised livers and spleens and punctured vessels. This current study investigated the long-term safety of HIFU in splenic hemostasis.


METHODS
A total of 21 rabbits were randomly assigned to two groups: HIFU treatment (n = 14), and sham treatment (n = 7). All animals underwent sterile laparotomy and splenic exposure. The HIFU-treated animals received splenic incisions, 8 to 10 mm long and 4 to 5 mm deep, and immediate 9.6-MHz HIFU until hemostasis was achieved. After recovery, ultrasound images, blood samples, and histologic samples were collected on days 0, 1, 3, 7, 14, 28, and 60.


RESULTS
All 14 splenic injuries were hemostatic after an average of 96 seconds of HIFU application. There was evidence of rebleeding in one animal between days 3 and 7 posttreatment. Subsequent blood analysis showed no significant difference in serial hematologic or coagulation measures between HIFU and sham groups. Histologic examination up to 60 days posttreatment revealed scarring and spleen tissue regeneration at the treatment site.


CONCLUSIONS
HIFU provides an effective and safe method of achieving hemostasis after acute splenic injury.
Noble
Misty L
ML
Center for Industrial and Medical Ultrasound, Applied Physics Laboratory, University of Washington, Seattle 98105, USA.
Vaezy
Shahram
S
Keshavarzi
Amid
A
Paun
Marla
M
Prokop
Adrian F
AF
Chi
Emil Y
EY
Cornejo
Carol
C
Sharar
Sam R
SR
Jurkovich
Gregory J
GJ
Martin
Roy W
RW
Crum
Lawrence A
LA
D000818:Animals; D004195:Disease Models, Animal; D005260:Female; D006470:Hemorrhage / Q000000981:diagnostic imaging / Q000401:mortality / Q000628:therapy*; D006489:Hemostatic Techniques; D008297:Male; D011817:Rabbits; D011897:Random Allocation; D012016:Reference Values; D012038:Regeneration / Q000502:physiology; D012680:Sensitivity and Specificity; D013158:Splenic Diseases / Q000000981:diagnostic imaging / Q000401:mortality / Q000628:therapy*; D016019:Survival Analysis; D016896:Treatment Outcome; D014464:Ultrasonic Therapy / Q000379:methods*; D014463:Ultrasonography