Diastolic timed Vibro-Percussion at 50 Hz delivered across a chest wall sized meat barrier enhances clot dissolution and remotely administered Streptokinase effectiveness in an in-vitro model of acute coronary thrombosis.
Diastolic timed Vibro-Percussion at 50 Hz delivered across a chest wall sized meat barrier enhances clot dissolution and remotely administered Streptokinase effectiveness in an in-vitro model of acute coronary thrombosis.
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DOI：
10.1186/1477-9560-10-23
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发表时间：
2012-11-12
影响因子：
3.1
通讯作者：
Gill H
中科院分区：
文献类型：
--
作者：
Hoffmann A;Gill H
低频振动-冲击（LFVP）有助于清除导管系统中的血栓，并且当应用于心脏并定时至血栓时，已知可增强冠状动脉血流。然而，需要研究在胸壁大小的屏障上接合的凝块冠状动脉样血管上的LFVP（类似于非侵入性心脏病发作治疗）。将1小时前的凝块（n=16）分配在Soft-Flo导管（4 mm管腔）的柔性段内，称重，与肝素化盐水（HS）连接，固定在弯曲的阻尼底座上，并拍照。将约4cm的肉板放置在节段上，并随机接受间歇性LFVP（以1秒间隔接合，-脱离）或无LFVP 20分钟。对HS进行脉冲（~120/80 mmHg），舒张期相协调以匹配LFVP输送。然后对节段重新拍照并吸出液体以确定凝块后重量。然后重复试验，在凝块上游约2 cm处递送0.5 ml链激酶（15，000 IU/100微升）。仅LFVP-HS样品（与对照相比）显示：a）对照组中不存在的凝块长度流体通道的形成（p < 0.0002）; B）溶解凝块混合评分增加（5.0 vs. 0.8，p < 2.8 E - 6）;和c）凝块溶解百分比增加（分别为23.0% vs. 1.8%，p < 8.5 E-6）。LFVP-SK样品具有类似的比较性凝块破坏特征，然而流体通道发展更快，并且凝块溶解百分比增加一倍以上（51.0%对3.0%，p<9.8E- 6）。舒张期定时LFVP（50 Hz）穿过胸壁大小的屏障，增强了对潜在冠状动脉样系统的凝块破坏作用。
Low Frequency Vibro-Percussion (LFVP) assists clearance of thrombi in catheter systems and when applied to the heart and timed to diastole is known to enhance coronary flow. However LFVP on a clotted coronary like vessel given engagement over a chest wall sized barrier (to resemble non-invasive heart attack therapy) requires study. One hour old clots (n=16) were dispensed within a flexible segment of Soft-Flo catheter (4 mm lumen), weighted, interfaced with Heparinized Saline (HS), secured atop a curved dampening base, and photographed. A ~4 cm meat slab was placed over the segment and randomized to receive intermittent LFVP (engaged, - disengaged at 1 second intervals), or no LFVP for 20 minutes. HS was pulsed (~120/80 mmHg), with the diastolic phase coordinated to match LFVP delivery. The segment was then re-photographed and aspirated of fluid to determine post clot weight. The trial was then repeated with 0.5 mls of Streptokinase (15,000 IU/100 microlitre) delivered ~ 2 cm upstream from the clot. LFVP - HS only samples (vs. controls) showed; a) development of clot length fluid channels absent in the control group (p < 0.0002); b) enhanced dissolved clot mixing scores ( 5.0 vs. 0.8, p < 2.8 E – 6); and c) increased percent clot dissolution (23.0% vs. 1.8% respectively, p < 8.5 E-6). LFVP - SK samples had a similar comparative clot disruptive profile, however fluid channels developed faster and percent clot dissolution more than doubled (51.0% vs. 3.0%, p< 9.8 E- 6). Diastolic timed LFVP (50 Hz) engaged across a chest wall sized barrier enhances clot disruptive effects to an underlying coronary like system.