Noninvasive extracorporeal thrombolysis using electrical discharge-induced shock waves: in vitro experiments.
OBJECTIVE
Many thrombectomy approaches have been developed for the treatment of venous thrombosis; however, no reference standard exists at this time. The aim of this study was to evaluate the efficacy of the transcutaneous application of electrical discharge-induced shock waves for thrombolysis in an in vitro model.


METHODS
Shock waves were applied on a thrombus positioned in a plasma-containing silicon tube using 2 different energy flux densities (0.53 and 2.26 mJ/mm). Depending upon the specific experiment, the thrombus was slightly moved to mimic pulsatory motions or/and additional Actilyse was added. Plasma samples were taken to determine the d-dimers before and after the application of shock waves.


RESULTS
Energy of 0.53 mJ/mm was insufficient for thrombolysis whereas the energy of 2.26 mJ/mm yielded a removal rate of up to 76.4% when the thrombus was slightly moved during the procedure. The amount of d-dimers correlated well with the addition of Actilyse. However, this did not affect the removal rate significantly.


CONCLUSIONS
The results demonstrate the potential of electrical discharge-induced shock waves for thrombolysis.
Katoh
Marcus
M
Department of Diagnostic Radiology, University Hospital, University of Technology (RWTH), Aachen, Germany. katoh@rad.rwth-aachen.de
Haage
Patrick
P
Pfeffer
Joachim G
JG
Wildberger
Joachim E
JE
Günther
Rolf W
RW
Tacke
Josef
J
D019220:High-Energy Shock Waves / Q000627:therapeutic use*; D006801:Humans; D008955:Models, Cardiovascular; D015912:Thrombolytic Therapy / Q000379:methods*; D013927:Thrombosis / Q000628:therapy*; D010959:Tissue Plasminogen Activator / Q000008:administration & dosage
D010959:Tissue Plasminogen Activator