Noninvasive in vivo clot dissolution without a thrombolytic drug - Recanalization of thrombosed iliofemoral arteries by transcutaneous ultrasound combined with intravenous infusion of microbubbles
Noninvasive in vivo clot dissolution without a thrombolytic drug - Recanalization of thrombosed iliofemoral arteries by transcutaneous ultrasound combined with intravenous infusion of microbubbles
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DOI：
10.1161/01.cir.97.2.130
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发表时间：
1998-01-20
期刊：
影响因子：
37.8
通讯作者：
Siegel, RJ
中科院分区：
文献类型：
--
作者：
Birnbaum, Y;Luo, H;Siegel, RJ
背景-以前的体内研究表明，微泡不仅可以在超声存在的情况下增强溶栓剂的有效性，而且可以在没有溶栓药物的情况下增加血栓的溶解。方法和结果-本研究的目的是通过静脉注射全氟化碳暴露的超声葡萄糖白蛋白(PESDA)和单独经皮传递超声，观察无创、非溶解的方法打破动脉血栓的有效性。10只兔的双股髂股动脉在急性动脉血栓闭塞和静脉注射Pesda后被随机分为经皮超声治疗和非超声治疗两组。另外3只兔的5条动脉作为对照(单独使用超声)。Pesda+超声治疗的10支髂股动脉在超声治疗后均行血管造影再通。Pesda单独处理的10支对侧动脉和单纯超声处理的5支动脉在1小时后均未通畅。D-二聚体水平在静脉注射Pesda+超声介导的再灌注后没有改变。结论：仅通过静脉微泡和经皮超声注射可以实现体内动脉血栓的溶解。这项技术在急性动脉和静脉血栓闭塞患者中具有临床应用的潜力。
Background-Previous in vivo studies have shown that microbubbles not only enhance the effectiveness of thrombolytic agents in the presence of ultrasound but may also augment clot dissolution without thrombolytic drugs.Methods and Results-The objective of this study was to examine the efficacy of arterial clot disruption by a noninvasive, nonlytic approach with intravenous administration of perfluorocarbon-exposed sonicated dextrose albumin (PESDA) and transcutaneous delivery of ultrasound alone. Pairs of iliofemoral arteries in 10 rabbits were randomized to receive transcutaneous ultrasound treatment or no ultrasound treatment after an acute artery thrombotic occlusion and intravenous PESDA infusion. Five arteries from 3 additional rabbits served as controls (ultrasound alone). All 10 iliofemoral arteries treated with PESDA + ultrasound were recanalized by angiography after ultrasound treatment. None of the the 10 contralateral arteries treated with PESDA alone and none of the 5 arteries treated with ultrasound alone were patent alter 1 hour. D-Dimer levels did not change after intravenous PESDA + ultrasound-mediated reperfusion.Conclusions-In vivo arterial clot dissolution can be achieved with intravenous microbubbles and transcutaneous ultrasound delivery alone. This technique has potential for clinical application in patients with acute arterial and venous thrombotic occlusions.