title: Enhanced detection of thromboemboli with the use of targeted microbubbles.
abstract: OBJECTIVE
  Targeted ultrasound contrast agents have recently been developed to adhere selectively to specific pathogenic materials such as plaque or thrombus. Administration of such microbubbles has potential to aid transcranial Doppler ultrasound (TCD) detection of emboli and to act as markers for distinguishing one embolic material from another. The purpose of this study was to investigate whether TCD detection of circulating thrombus emboli would be enhanced by the addition of targeted microbubbles.
  
  
  METHODS
  Binding of microbubbles to the surface of the thrombus was confirmed by scanning electron microscopy. Targeted and control bubbles were then introduced to thrombus and tissue-mimicking material circulated under pulsatile-flow conditions in an in vitro flow rig. Embolic signal intensities before and after introduction of the bubbles were measured by TCD.
  
  
  RESULTS
  Targeted microbubbles enhanced TCD signal intensities from thrombus emboli by up to 13 dB. The bubbles were capable of binding to moving thrombus when injected into the flow circuit in low concentrations ( approximately 36 bubbles per 100 mL) and were retained on the thrombus under pulsatile-flow conditions. Signal intensities from similarly sized pieces of tissue-mimicking material were not enhanced by injection of targeted bubbles.
  
  
  CONCLUSIONS
  Injection of appropriately targeted microbubbles significantly enhances TCD detection of circulating thrombus emboli in vitro.
authors.affiliation: Department of Cardiovascular Sciences, University of Leicester, Leicester, UK.
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Martin
authors.forename: Emma M L
authors.initials: EM
authors.lastname: Chung
authors.forename: Alison H
authors.initials: AH
authors.lastname: Goodall
authors.forename: Alberto
authors.initials: A
authors.lastname: Della Martina
authors.forename: Kumar V
authors.initials: KV
authors.lastname: Ramnarine
authors.forename: Lingke
authors.initials: L
authors.lastname: Fan
authors.forename: Sarah V
authors.initials: SV
authors.lastname: Hainsworth
authors.forename: A Ross
authors.initials: AR
authors.lastname: Naylor
authors.forename: David H
authors.initials: DH
authors.lastname: Evans
mesh_terms: D000077284:Abciximab; D000911:Antibodies, Monoclonal; D006801:Humans; D007140:Immunoglobulin Fab Fragments; D066298:In Vitro Techniques; D020766:Intracranial Embolism / Q000000981:diagnostic imaging*; D045423:Microbubbles; D008855:Microscopy, Electron, Scanning; D008955:Models, Cardiovascular; D010975:Platelet Aggregation Inhibitors; D011673:Pulsatile Flow; D017585:Ultrasonography, Doppler, Transcranial / Q000379:methods*