Microbubble potentiated ultrasound as a method of declotting thrombosed dialysis grafts: Experimental study in dogs

William C. Culp, Thomas R. Porter, Feng Xie, Timothy C. Goertzen, Timothy C. McCowan, Brian N. Vonk, Bernard T. Baxter

Research output: Contribution to journalArticle

53 Scopus citations

Abstract

Intravenous perfluorocarbon-exposed sonicated dextrose albumin (PESDA) microbubbles in the presence of low frequency ultrasound (LFUS) can lyse very small clots. We develop a similar method to declot full-size arteriovenous dialysis grafts. Dialysis grafts fashioned in three dogs were cannulated and ligated. After thrombosis, three declotting techniques were randomly applied: 1) direct injection of PESDA + LFUS; 2) direct injection of saline + LFUS; and 3) intravenous PESDA + LFUS. Declotting was graded by cine angiography scores of each third of the graft on a scale of 0-4 (maximum total score = 12). Twenty-six procedures showed mean patency scores of 11.1 for direct PESDA and 8.4 for IV PESDA, vs 4.9 for direct saline, p = <0.001. All eight direct PESDA injections achieved lysis and good flow, but none of 8 direct saline injections succeeded, p = <0.01. Intravenous PESDA succeeded in 4 of 10 procedures, p = <0.04 vs saline. Direct injection of PESDA with transcutaneous LFUS succeeds in lysing moderate-size clots and recanalizing thrombosed fistulas.

Original languageEnglish (US)
Pages (from-to)407-412
Number of pages6
JournalCardiovascular and Interventional Radiology
Volume24
Issue number6
DOIs
StatePublished - 2001

Keywords

  • Dialysis
  • Revascularization
  • Thrombolysis
  • Ultrasonics

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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