title: Contrast-enhanced sonothrombolysis in a porcine model of acute peripheral arterial thrombosis and prevention of anaphylactic shock.
abstract: Acute peripheral arterial thrombosis can be threatening to life and limb. Dissolution of the thrombus local catheter-directed intra-arterial infusion of fibrinolytic agents such as urokinase is the standard therapy for thrombosis; however, this method is time-intensive, and amputation of the affected limb is still needed in 10-30% of cases. Furthermore, thrombolytic therapy carries the risk of bleeding complications. The use of small gas-filled bubbles, or ultrasound contrast agents (UCAs), in combination with ultrasound has been investigated as an improved thrombolytic therapy in acute coronary and cerebral arterial thrombosis. The authors describe a porcine model of acute peripheral arterial occlusion to test contrast-enhanced sonothrombolysis approaches that combine ultrasound, UCAs and fibrinolytic agents and recommend a strategy for preventing severe allergic reactions to UCAs in the pigs.
authors.affiliation: Department of Surgery, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Johanna H
authors.initials: JH
authors.lastname: Nederhoed
authors.affiliation: Department of Cardiology, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Jeroen
authors.initials: J
authors.lastname: Slikkerveer
authors.affiliation: Amsterdam Animal Research Center, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Klaas W
authors.initials: KW
authors.lastname: Meyer
authors.affiliation: Department of Surgery, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Willem
authors.initials: W
authors.lastname: Wisselink
authors.affiliation: Department of Physiology, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: René J P
authors.initials: RJ
authors.lastname: Musters
authors.affiliation: 1] Department of Surgery, VU University Medical Center, Amsterdam, The Netherlands. [2] Department of Physiology, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Kak K
authors.initials: KK
authors.lastname: Yeung
mesh_terms: D000707:Anaphylaxis / Q000139:chemically induced / Q000517:prevention & control; D000818:Animals; D002317:Cardiovascular Agents / Q000008:administration & dosage / Q000191:economics / Q000494:pharmacology; D003287:Contrast Media / Q000494:pharmacology*; D005260:Female; D007213:Indomethacin / Q000008:administration & dosage / Q000191:economics / Q000494:pharmacology; D008055:Lipids / Q000009:adverse effects; D061185:Mechanical Thrombolysis / Q000379:methods*; D045423:Microbubbles / Q000009:adverse effects; D058729:Peripheral Arterial Disease / Q000473:pathology / Q000628:therapy*; D011292:Premedication; D013552:Swine; D013927:Thrombosis / Q000473:pathology / Q000628:therapy*
chemical_list: D002317:Cardiovascular Agents; D003287:Contrast Media; D008055:Lipids; D007213:Indomethacin