Thromboembolism in blood vessels poses a serious risk of stroke,heart attack,and even sudden death if not properly managed.Sonothrombolysis combined with ultrasound contrast agents has emerged as a promising approach ...Thromboembolism in blood vessels poses a serious risk of stroke,heart attack,and even sudden death if not properly managed.Sonothrombolysis combined with ultrasound contrast agents has emerged as a promising approach for the effective treatment of thromboembolism.Recent reports have highlighted the potential of intravascular sonothrombolysis as a safe and effective treatment modality for deep vein thrombosis(DVT).However,its efficiency has not been validated through in vivo testing of retracted clots.This study aimed to develop a miniaturized multidirectional transducer featuring two 4-layer lead zir-conate titanate(PZT-5A)stacks with an aperture size of 1.4 mm1.4 mm,enabling both forward-and side-looking treatment.Integrated into a custom two-lumen 10-French(Fr)catheter,the capability of this device for intravascular sonothrombolysis was validated both in vitro and in vivo.With low-dose tissue plasminogen activators and nanodroplets,the rotational multidirectional transducer reduced the retracted clot mass(800 mg)by an average of 52%within 30 min during in vitro testing.The lysis rate was significantly higher by 37%than that in a forward-viewing transducer without rotation.This improvement was particularly noteworthy in the treatment of retracted clots.Notably,a long-retracted clot(>10 cm)was successfully treated within 40 min in vivo by creating a flow channel with a diameter>4 mm in a porcine DVT model.In conclusion,these findings strongly suggest the potential of this technique for clinical applications in sonothrombolysis,offering a feasible solution for effectively treating thromboembolism,particularly in challenging cases involving retracted clots.展开更多
基金supported by National Institute of Health(NIH)grants(R01HL141967 and R21EB027304).
文摘Thromboembolism in blood vessels poses a serious risk of stroke,heart attack,and even sudden death if not properly managed.Sonothrombolysis combined with ultrasound contrast agents has emerged as a promising approach for the effective treatment of thromboembolism.Recent reports have highlighted the potential of intravascular sonothrombolysis as a safe and effective treatment modality for deep vein thrombosis(DVT).However,its efficiency has not been validated through in vivo testing of retracted clots.This study aimed to develop a miniaturized multidirectional transducer featuring two 4-layer lead zir-conate titanate(PZT-5A)stacks with an aperture size of 1.4 mm1.4 mm,enabling both forward-and side-looking treatment.Integrated into a custom two-lumen 10-French(Fr)catheter,the capability of this device for intravascular sonothrombolysis was validated both in vitro and in vivo.With low-dose tissue plasminogen activators and nanodroplets,the rotational multidirectional transducer reduced the retracted clot mass(800 mg)by an average of 52%within 30 min during in vitro testing.The lysis rate was significantly higher by 37%than that in a forward-viewing transducer without rotation.This improvement was particularly noteworthy in the treatment of retracted clots.Notably,a long-retracted clot(>10 cm)was successfully treated within 40 min in vivo by creating a flow channel with a diameter>4 mm in a porcine DVT model.In conclusion,these findings strongly suggest the potential of this technique for clinical applications in sonothrombolysis,offering a feasible solution for effectively treating thromboembolism,particularly in challenging cases involving retracted clots.
