Prostate histotripsy in an anticoagulated model.
Prostate histotripsy in an anticoagulated model.
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DOI：
10.1016/j.urology.2009.09.021
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发表时间：
2010-01
期刊：
影响因子：
2.1
通讯作者：
Roberts WW
中科院分区：
文献类型：
--
作者：
Wheat JC;Hall TL;Hempel CR;Cain CA;Xu Z;Roberts WW
组织切片术是一种非侵入性超声技术，它在组织内诱导微泡形成（空化），产生机械组织分离。在前列腺消融的初步体内可行性犬研究中，观察到极少血尿。在目前的研究中，我们试图通过对抗凝犬进行广泛的前列腺组织切片治疗来进一步探索这一现象。使用体外750 kHz治疗性超声换能器向前列腺尿道和尿道周围实质传递声脉冲，对9只犬进行组织切片，预先口服6 mg华法林3 ~ 5天。7-28 d后安乐死，行经直肠前列腺超声检查，取前列腺。在组织切片治疗前和安乐死时立即测定血清血红蛋白和国际正常化比率（INR）。平均治疗INR为4.6（中位数为2.4，范围1.2至11.3）。与基线相比，安乐死时血红蛋白浓度无临床显著变化。在收获时，前列腺的组织学切片显示一个与计划治疗体积相对应的大腔，包括前列腺尿道和所有受试者的实质。治疗2天内尿清，未见血凝块。尽管进行了治疗性和超治疗性抗凝治疗，但组织切片检查导致少量出血，尽管前列腺有明显的分离和组织缩小。这些结果促使进一步研究了解组织切片下的非热止血机制。
Histotripsy is a non-invasive ultrasound technology which induces microbubble formation (cavitation) within tissues producing mechanical tissue fractionation. During initial in-vivo feasibility canine studies of prostate ablation, minimal hematuria was observed. In the current study, we sought to further explore this phenomenon by performing extensive prostate histotripsy treatments in anticoagulated canines. Histotripsy was performed on 9 canine subjects pre-treated with 6 mg of oral warfarin for 3 to 5 days using an extracorporeal 750 kHz therapeutic ultrasound transducer delivering acoustic pulses to the prostatic urethra and periurethral parenchyma. After 7–28 days, the subjects were euthanized, transrectal prostate ultrasound was performed and the prostate was harvested. Serum hemoglobin and International Normalization Ratio (INR) were measured immediately prior to histotripsy treatment and at euthanasia. Mean treatment INR was 4.6 (median 2.4, range 1.2 to 11.3). There was no clinically significant change in hemoglobin concentration at euthanasia compared to baseline. At harvest, histologic sections of the prostate revealed a large cavity corresponding to the planned treatment volume incorporating the prostatic urethra and parenchyma in all subjects. Urine was clear within 2 days of treatment and no blood clots were seen. Despite therapeutic and supratherapeutic anticoagulation, histotripsy resulted in minimal bleeding despite significant fractionation and tissue debulking of the prostate. These results have prompted further studies to understand the mechanism of non-thermal hemostasis underlying histotripsy.
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影响因子：
2.4
作者：
Xu, Z;Fowlkes, JB;Cain, CA
通讯作者：
Cain, CA
DOI：
10.1109/tuffc.2003.1244746
发表时间：
2003-10-01
影响因子：
3.6
作者：
Tran, BC;Seo, J;Cain, CA
通讯作者：
Cain, CA
影响因子：
1
作者：
Monnet, E;Morgan, MR
通讯作者：
Morgan, MR
影响因子：
2.1
作者：
Hall, Timothy L.;Hempel, Christopher R.;Wojno, Kirk;Xu, Zhen;Cain, Charles A.;Roberts, William W.
通讯作者：
Roberts, William W.
影响因子：
23.4
作者：
Rassweiler, Jens;Teber, Doqu;Hofmann, Rainer
通讯作者：
Hofmann, Rainer