Unexpected High Incidence of Coronary Vasoconstriction in the Reduction of Microvascular Injury Using Sonolysis (ROMIUS) Trial

Sebastiaan T. Roos, Lynda J.M. Juffermans, Niels van Royen, Albert C. van Rossum, Feng Xie, Yolande Appelman, Thomas R. Porter, Otto Kamp

Research output: Contribution to journalArticlepeer-review

20 Scopus citations


High-mechanical-index ultrasound and intravenous microbubbles might prove beneficial in treating microvascular obstruction caused by microthrombi after primary percutaneous coronary intervention for ST-segment elevation myocardial infarction (STEMI). Experiments in animals have revealed that longer-pulse-duration ultrasound is associated with an improvement in microvascular recovery. This trial tested long-pulse-duration, high-mechanical-index ultrasound in STEMI patients. Non-randomly assigned, non-blinded patients were included in this phase 2 trial. The primary endpoint was any side effect possibly related to the ultrasound treatment. The study was aborted after six patients were included; three patients experienced coronary vasoconstriction of the culprit artery, unresponsive to nitroglycerin. Therefore, coronary artery diameter was measured in five pigs. Coronary artery diameters distal to the injury site decreased after application of ultrasound, after balloon injury plus thrombus injection (from 1.89 ± 0.24 mm before to 1.78 ± 0.17 after ultrasound, p = 0.05). Long-pulse-duration ultrasound might cause coronary vasoconstriction distal to the culprit vessel location.

Original languageEnglish (US)
Pages (from-to)1919-1928
Number of pages10
JournalUltrasound in Medicine and Biology
Issue number8
StatePublished - Aug 1 2016


  • Microvascular obstruction
  • Myocardial infarction
  • Sonothrombolysis
  • Theragnostic ultrasound
  • Ultrasound contrast agents

ASJC Scopus subject areas

  • Biophysics
  • Radiological and Ultrasound Technology
  • Acoustics and Ultrasonics


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