Noninvasive thrombolysis using pulsed ultrasound cavitation therapy - histotripsy.
Noninvasive thrombolysis using pulsed ultrasound cavitation therapy - histotripsy.
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DOI：
10.1016/j.ultrasmedbio.2009.07.001
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发表时间：
2009-12
影响因子：
2.9
通讯作者：
Xu, Zhen
中科院分区：
文献类型：
--
作者：
Maxwell, Adam D.;Cain, Charles A.;Duryea, Alexander P.;Yuan, Lingqian;Gurm, Hitinder S.;Xu, Zhen
临床上可用的溶栓技术受到缓慢再灌流(药物)或侵袭性(导管)的限制，并有很大的出血风险。在这项研究中，组织摩擦学作为一种有效的非侵入性溶栓技术的可行性进行了研究。组织摩擦通过使用聚焦的、短的、高强度的超声脉冲通过受控的空化来分割软组织。用组织摩擦学方法处理新鲜犬血形成的体外血栓。治疗使用聚焦1 MHz换能器，以1 kHz的脉冲重复率进行5个周期的脉冲。测试声压从2~12兆帕的峰值负压变化。我们的结果表明，组织碎石术可以单独使用超声能量进行有效的溶栓。组织学溶栓仅在峰值负压≥6 Mpa时进行，当声学背向散射监测检测到空化泡状云的启动时。重330 mg的血栓经组织学检查1.5~5分钟即可完全破碎。血块被分割成碎片，其中96%的重量小于5μm直径。在快速、脉动的血流(循环模型)和静态生理盐水中，组织旅行溶栓治疗仍然有效。此外，我们观察到空化云产生的液体流可以吸引、捕获并进一步分解凝块碎片。这种现象可能为在溶栓过程中过滤和消除危险栓子提供一种非侵入性的方法。
Clinically available thrombolysis techniques are limited by either slow reperfusion (drugs) or invasiveness (catheters), and carry significant risks of bleeding. In this study, the feasibility of using histotripsy as an efficient and non-invasive thrombolysis technique was investigated. Histotripsy fractionates soft tissue through controlled cavitation using focused, short, high-intensity ultrasound pulses. In-vitro blood clots formed from fresh canine blood were treated by histotripsy. The treatment was applied using a focused 1-MHz transducer, with 5-cycle pulses at a pulse repetition rate of 1 kHz. Acoustic pressures varying from 2 – 12 MPa peak negative pressure were tested. Our results show that histotripsy can perform effective thrombolysis with ultrasound energy alone. Histotripsy thrombolysis only occurred at peak negative pressure ≥6 MPa when initiation of a cavitating bubble cloud was detected using acoustic backscatter monitoring. Blood clots weighing 330 mg were completely broken down by histotripsy in 1.5 – 5 minutes. The clot was fractionated to debris with >96% weight smaller than 5 μm diameter. Histotripsy thrombolysis treatment remained effective under a fast, pulsating flow (a circulatory model) as well as in static saline. Additionally, we observed that fluid flow generated by a cavitation cloud can attract, trap, and further break down clot fragments. This phenomenon may provide a non-invasive method to filter and eliminate hazardous emboli during thrombolysis.
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影响因子：
2.9
作者：
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