Abstract
Clinically available thrombolysis techniques are limited by either slow reperfusion
(drugs) or invasiveness (catheters) and carry significant risks of bleeding. In this
study, the feasibility of using histotripsy as an efficient and noninvasive thrombolysis
technique was investigated. Histotripsy fractionates soft tissue through controlled
cavitation using focused, short, high-intensity ultrasound pulses. In vitro blood clots formed from fresh canine blood were treated by histotripsy. The treatment
was applied using a focused 1-MHz transducer, with five-cycle pulses at a pulse repetition
rate of 1 kHz. Acoustic pressures varying from 2 to 12 MPa peak negative pressure were tested. Our results show that histotripsy can perform
effective thrombolysis with ultrasound energy alone. Histotripsy thrombolysis only
occurred at peak negative pressure ≥6 MPa when initiation of a cavitating bubble cloud was detected using acoustic backscatter
monitoring. Blood clots weighing 330 mg were completely broken down by histotripsy in 1.5 to 5 min. The clot was fractionated to debris with >96% weight smaller than 5 μm diameter. Histotripsy thrombolysis treatment remained effective under a fast, pulsating
flow (a circulatory model) as well as in static saline. Additionally, we observed
that fluid flow generated by a cavitation cloud can attract, trap and further break
down clot fragments. This phenomenon may provide a noninvasive method to filter and
eliminate hazardous emboli during thrombolysis. (E-mail: [email protected])
Key words
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Article info
Publication history
Published online: October 26, 2009
Accepted:
July 7,
2009
Received in revised form:
May 24,
2009
Received:
October 9,
2008
Identification
Copyright
© 2009 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.
