Noninvasive in vivo clot dissolution without a thrombolytic drug: Recanalization of thrombosed iliofemoral arteries by transcutaneous ultrasound combined with intravenous infusion of microbubbles

Yochai Birnbaum, Huai Luo, Tomoo Nagai, Michael C. Fishbein, Thomas M. Peterson, Shouping Li, David Kricsfeld, Thomas R. Porter, Robert J. Siegel

Research output: Contribution to journalArticle

150 Scopus citations

Abstract

Background - Previous in vivo studies have shown that microbubbles not only enhance the effectiveness of thrombolytic agents in the presence of ultrasound but may also augment clot dissolution without thrombolytic drugs. Methods and Results - The objective of this study was to examine the efficacy of arterial clot disruption by a noninvasive, nonlyric approach with intravenous administration of perfluorocarbon-exposed sonicated dextrose albumin (PESDA) and transcutaneous delivery of ultrasound alone. Pairs of iliofemoral arteries in 10 rabbits were randomized to receive transcutaneous ultrasound treatment or no ultrasound treatment after an acute artery thrombotic occlusion and intravenous PESDA infusion. Five arteries from 3 additional rabbits served as controls (ultrasound alone). All 10 iliofemoral arteries treated with PESDA + ultrasound were recanalized by angiography after ultrasound treatment. None of the 10 contralateral arteries treated with PESDA alone and none of the 5 arteries treated with ultrasound alone were patent after 1 hour. D-Dimer levels did not change after intravenous PESDA+ultrasound-mediated reperfusion. Conclusions - In vivo arterial clot dissolution can be achieved with intravenous microbubbles and transcutaneous ultrasound delivery alone. This technique has potential for clinical application in patients with acute arterial and venous thrombotic occlusions.

Original languageEnglish (US)
Pages (from-to)130-134
Number of pages5
JournalCirculation
Volume97
Issue number2
DOIs
StatePublished - 1998

Keywords

  • Occlusion
  • Thrombosis
  • Ultrasonics

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

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