High-intensity focused ultrasound (HIFU) for dissolution of clots in a rabbit model of embolic stroke.
High-intensity focused ultrasound (HIFU) for dissolution of clots in a rabbit model of embolic stroke.
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高强度聚焦超声（HIFU）用于栓塞兔模型中凝块的溶解。
DOI：
10.1371/journal.pone.0042311
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发表时间：
2012
期刊：
影响因子：
3.7
通讯作者：
Hynynen K
中科院分区：
文献类型：
--
作者：
Burgess A;Huang Y;Waspe AC;Ganguly M;Goertz DE;Hynynen K
据估计，只有2-6%的急性缺血性卒中患者接受溶栓治疗，这表明替代疗法是必要的。在这项研究中，我们调查的潜力高强度聚焦超声（HIFU）开始溶栓在栓塞模型中风。将载铁血凝块经颈内动脉注入新西兰白色兔的大脑中动脉（MCA），并通过血管造影术证实阻塞。MRI用于定位负载铁的凝块并瞄准HIFU束进行治疗。施加HIFU脉冲（1.5 MHz，1 ms脉冲群，1 Hz脉冲重复频率，20 s持续时间）以启动血栓溶解。重复血管造影和组织学用于评估再灌注和血管损伤。使用275 W的声功率，在3只受试兔的治疗后血管造影中没有再灌注的证据。在另一组动物中，施加415 W的声功率，在4只治疗动物中的2只（50%）中观察到再灌注。在最后一组动物中，声功率进一步增加到550 W，这导致7只测试动物中的5只（约70%）再灌注。组织学分析证实，超声处理后的血管保持完整。在超声处理部位外检测到出血，可能是由于靶血管与家兔颅底接近。这些结果证明了使用HIFU作为独立方法的可行性，可以在不立即损伤靶血管的情况下引起有效的溶栓。HIFU与用于识别和评估卒中患者的成像模式相结合，可以显著缩短患者实现血流恢复的时间，从而显著增加从溶栓治疗中受益的患者数量。
It is estimated that only 2–6% of patients receive thrombolytic therapy for acute ischemic stroke suggesting that alternative therapies are necessary. In this study, we investigate the potential for high intensity focused ultrasound (HIFU) to initiate thrombolysis in an embolic model of stroke. Iron-loaded blood clots were injected into the middle cerebral artery (MCA) of New Zealand White rabbits, through the internal carotid artery and blockages were confirmed by angiography. MRI was used to localize the iron-loaded clot and target the HIFU beam for treatment. HIFU pulses (1.5 MHz, 1 ms bursts, 1 Hz pulse repetition frequency, 20 s duration) were applied to initiate thrombolysis. Repeat angiograms and histology were used to assess reperfusion and vessel damage. Using 275 W of acoustic power, there was no evidence of reperfusion in post-treatment angiograms of 3 rabbits tested. In a separate group of animals, 415 W of acoustic power was applied and reperfusion was observed in 2 of the 4 (50%) animals treated. In the last group of animals, acoustic power was further increased to 550 W, which led to the reperfusion in 5 of 7 (∼70%) animals tested. Histological analysis confirmed thatthe sonicated vessels remained intact after HIFU treatment. Hemorrhage was detected outside of the sonication site, likely due to the proximity of the target vessel with the base of the rabbit skull. These results demonstrate the feasibility of using HIFU, as a stand-alone method, to cause effective thrombolysis without immediate damage to the targeted vessels. HIFU, combined with imaging modalities used to identify and assess stroke patients, could dramatically reduce the time to achieve flow restoration in patients thereby significantly increasing the number of patients which benefit from thrombolysis treatments.
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影响因子：
19.7
作者：
Hynynen, K;Vykhodtseva, NI;Jolesz, FA
通讯作者：
Jolesz, FA
影响因子：
19.7
作者：
Hynynen, K;McDannold, N;Jolesz, FA
通讯作者：
Jolesz, FA
影响因子：
9.9
作者：
Barber, PA;Zhang, J;Buchan, AM
通讯作者：
Buchan, AM
影响因子：
2.9
作者：
Maxwell, Adam D.;Owens, Gabe;Gurm, Hitinder S.;Ives, Kimberly;Myers, Daniel D., Jr.;Xu, Zhen
通讯作者：
Xu, Zhen
影响因子：
8.3
作者：
Alexandrov, Andrei V.;Mikulik, Robert;Grotta, James C.
通讯作者：
Grotta, James C.