Treatment of acute intravascular thrombi with diagnostic ultrasound and intravenous microbubbles.
The purpose of this study was to determine whether high mechanical index (MI) impulses from diagnostic ultrasound (DUS) could dissolve intravascular thrombi using intravenous microbubbles. Using a canine model, DUS was applied during a continuous intravenous infusion of microbubbles. Completely thrombosed grafts were assigned to 2 treatment regimens: low-MI (<0.5-MI) ultrasound alone; or intermittent high-MI impulses (1.9-MI) guided by low-MI ultrasound (contrast pulse sequencing). A 20-MHz cavitation detector was placed confocal to the ultrasound transducer to make intravascular cavitation measurements in 1 dog. Intravascular cavitational activity was detected when an MI of >0.5 was applied. In grafts treated with intermittent high-MI ultrasound, angiographic success was 71% at 30 min and 79% at 45 min, compared with 20% and 30% at these times in the low-MI ultrasound alone group (p < 0.05). We conclude that a commercially available DUS transducer can successfully recanalize acute intravascular thrombi during a continuous microbubble infusion.
Xie
Feng
F
Department of Internal Medicine/Section of Cardiology, University of Nebraska Medical Center, Omaha, NE 68198-2265, USA.
Lof
John
J
Everbach
Carr
C
He
Anming
A
Bennett
Richard M
RM
Matsunaga
Terry
T
Johanning
Jason
J
Porter
Thomas R
TR
D000208:Acute Disease; D000818:Animals; D003287:Contrast Media / Q000008:administration & dosage*; D004195:Disease Models, Animal; D004285:Dogs; D004867:Equipment Design; D005466:Fluorocarbons / Q000008:administration & dosage*; D005740:Gases; D006083:Graft Occlusion, Vascular / Q000000981:diagnostic imaging / Q000628:therapy*; D007262:Infusions, Intravenous; D045423:Microbubbles; D013927:Thrombosis / Q000000981:diagnostic imaging / Q000628:therapy*; D013997:Time Factors; D014160:Transducers, Pressure; D014464:Ultrasonic Therapy / Q000295:instrumentation; D018084:Ultrasonography, Interventional / Q000295:instrumentation
D003287:Contrast Media; D005466:Fluorocarbons; D005740:Gases