Forward viewing catheter-delivered microbubble enhanced sonothrombolysis (FV-CAMUS)

前视导管输送微泡增强超声溶栓(FV-CAMUS) 深静脉血栓形成(DVT)所致的肺栓塞(PE)每年导致超过10万人死亡 仅在美国。最新创新的溶栓治疗技术，如药物溶解 或纤溶和机械碎裂，已显示出进展性结果，但仍遭受严重 溶栓效率低、治疗时间长、出血并发症多、 失败率、静脉损伤合并严重的局部功能障碍、复发和相对较大的颗粒 可导致远端血栓形成的残余血栓碎片的大小。这引起了人们对声学溶栓的极大兴趣， 使用聚焦超声破坏血栓，但目前商用的超声溶栓系统(如EKOS) 仍然受限于较长的治疗时间和由于加热和过多的声音造成的周围组织损伤 曝光。最近，我们的团队和其他人展示了几项有望改进的进展 微泡介导法溶栓治疗的效果(显著缩短治疗时间)和安全性 基于前瞻性的双频导管技术。我们假设一种新技术的发展 多频工具与空化增强剂相结合的导管超声溶栓方法 可以大大提高这种方法的有效性、安全性和影响力。在这个项目中，我们开发了创新的 来自我们协作组的技术，每一项都显示出明显的优势 技术，我们假设它们共同可以克服前述 急性栓塞症治疗。具体地说，一个4法式导管将与双声源整合在一起--a 小口径双频前视超声换能器，结合微管输送 微泡和裂解剂(组织型纤溶酶原激活剂或t-PA)，以实现前视导管- 注射微泡增强超声溶栓(FV-CAMUS)。FV-Camus导管将被设计出来， 进行了大动物的体外、体外和体内溶栓试验。这个 建议的FV-CAMU技术将提供一种新的工具，使血栓治疗准确、快速和安全。

Forward viewing catheter-delivered microbubble enhanced sonothrombolysis (FV-CAMUS) Deep vein thrombosis (DVT) induced pulmonary embolism (PE) causes more than 0.1 million deaths annually in the US alone. Recent innovative treatment techniques for thrombolysis, such as pharmacological dissolution or fibrinolysis and mechanical fragmentation, have showed progressive results, yet still suffer from severe limitations such as low thrombolysis efficiency and long treatment times, frequent bleeding complications, high failure rate, vein injury associated with severe regional dysfunction, recurrence, and the relatively large particle size of residual clot debris which can result in distal embolism. This has led to great interest in sonothrombolysis, the use of focused ultrasound to disrupt clots, yet current commercial sonothrombolysis systems (e.g. EKOS) are still limited by long treatment times and peripheral tissue damage due to heating and excessive acoustic exposure. More recently, our group and others have demonstrated several advances which promise to improve the performance (significantly reduced treatment time) and safety of thrombolysis using a microbubble-mediated forward-looking dual frequency catheter based technology. We hypothesize that the development of a new approach for catheter sonothrombolysis combining multi-frequency tools as well as cavitation-enhancing agents can substantially improve the efficacy, safety, and impact of this approach. In this project, we develop innovative technologies from our collaborative group, each of which has shown notable advantages over current technology, and we hypothesize that together they can overcome existing challenges in the aforementioned acute embolism treatments. Specifically, a 4-French catheter will be integrated with dual acoustic sources - a small aperture dual frequency forward-looking ultrasound transducer, combined with a micro-tube for delivery of microbubbles and lytic agent (tissue-type plasminogen activator or t-PA), to achieve Forward Viewing CAtheter- delivered MicrobUbble enhanced Sonothrombolysis (FV-CAMUS). The FV-CAMUS catheter will be designed, prototyped and characterized, followed by in-vitro, ex-vivo and in-vivo thrombolysis tests in large animals. The proposed FV-CAMUS technology will provide a new tool enabling accurate, fast, and safe thrombus treatment.