An Endovascular Model of Carotid Stenosis for the Evaluation of Thrombolysis and Angioplasty

Lin, Peter H.; Surowiec, Scott M.; Conklin, Brian S.; Bush, Ruth L.; Chen, Changyi; Chaikof, Elliot L.; Lumsden, Alan B.

doi:10.1177/152660280000700609

Cited by 3 publications

(2 citation statements)

References 29 publications

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“…CT with local contrast agent injection is associated with considerable beam-hardening artifacts as a result of high concentration of contrast agent within the lysis catheter and unnecessary radiation exposure to the operator. Therefore, the increase of patent graft area was examined by angiography, consistent with clinical practice and previous publications (19,35,36). The use of an edge detection program increased the accuracy and reproducibility of the contrast area measurements as opposed to manual segmentation; adjustments were made by the blinded reviewer if necessary.…”

Section: Discussionmentioning

confidence: 89%

Pulsed High–Intensity-focused US and Tissue Plasminogen Activator (TPA) Versus TPA Alone for Thrombolysis of Occluded Bypass Graft in Swine

Abi-Jaoudeh

Pritchard

Amalou

et al. 2012

Journal of Vascular and Interventional Radiology

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Purpose Prosthetic arteriovenous or arterial-arterial bypass grafts can thrombose and be resistant to revascularization. A thrombosed bypass graft model was created to evaluate the potential therapeutic enhancement and safety profile of pulsed high-intensity-focused ultrasound (pHIFU) on pharmaceutical thrombolysis. Materials and Methods In swine, a right carotid-carotid expanded polytetrafluoroethylene bypass graft was surgically constructed, containing a 40% stenosis at its distal end to induce graft thrombosis. The revascularization procedure was performed 7 days after surgery. After model development and dose response experiments (n = 11), two cohorts were studied: pHIFU with tissue plasminogen activator (TPA; n = 4) and sham pHIFU with TPA (n = 3). The experiments were identical in both groups except no energy was delivered in the sham pHIFU group. Serial angiograms were obtained in all cases. The area of graft opacified by contrast medium on angiograms was quantified with digital image processing software. A blinded reviewer calculated the change in the graft area opacified by contrast medium and expressed it as a percentage, representing percentage of thrombolysis. Results Combining pHIFU with 0.5 mg of TPA resulted in a 52% ± 4% increase in thrombolysis on angiograms obtained at 30 minutes, compared with a 9% ± 14% increase with sham pHIFU and 0.5 mg TPA (P = .003). Histopathologic examination demonstrated no differences between the groups. Conclusions Thrombolysis of occluded bypass grafts was significantly increased when combining pHIFU and TPA versus sham pHIFU and TPA. These results suggest that application of pHIFU may augment thrombolysis with a reduced time and dose.

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Section: Discussionmentioning

confidence: 89%

Pulsed High–Intensity-focused US and Tissue Plasminogen Activator (TPA) Versus TPA Alone for Thrombolysis of Occluded Bypass Graft in Swine

Abi-Jaoudeh

Pritchard

Amalou

et al. 2012

Journal of Vascular and Interventional Radiology

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“…13 Our laboratory had previously reported the preservation of endothelial function and vasomotor response following manual PMT therapy in experimental chronic DVT. 14,15 In an effort to further understand the endothelial response to percutaneous thrombectomy therapy in a chronic DVT setting, we sought to evaluate the effect of the AngioJet RT system using the PMT technique on endothelial function and thrombogenicity in a porcine chronic DVT model.…”

mentioning

confidence: 99%

Rheolytic Pharmacomechanical Thrombectomy in Experimental Chronic Deep Vein Thrombosis: Effect of L‐Arginine on Thrombogenicity and Endothelial Vasomotor Function

et al. 2007

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AngioJet RT and PMT interventions resulted in similar attenuated endothelium-dependent vasoreactivity and morphologic effect. L-Arginine supplementation preserves endothelial vasoreactivity and reduces platelet deposition following PMT in iliac DVT. Additionally, L-arginine enhances NO production at sites of venous thrombosis. The NO precursor L-arginine may have a therapeutic potential in preserving endothelial function following mechanical thrombectomy.

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L-arginine improves endothelial vasoreactivity and reduces thrombogenicity after thrombolysis in experimental deep venous thrombosis

Lin

Johnson

Pullium

et al. 2003

Journal of Vascular Surgery

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An Endovascular Model of Carotid Stenosis for the Evaluation of Thrombolysis and Angioplasty

Cited by 3 publications

References 29 publications

Pulsed High–Intensity-focused US and Tissue Plasminogen Activator (TPA) Versus TPA Alone for Thrombolysis of Occluded Bypass Graft in Swine

Pulsed High–Intensity-focused US and Tissue Plasminogen Activator (TPA) Versus TPA Alone for Thrombolysis of Occluded Bypass Graft in Swine

Rheolytic Pharmacomechanical Thrombectomy in Experimental Chronic Deep Vein Thrombosis: Effect of L‐Arginine on Thrombogenicity and Endothelial Vasomotor Function

L-arginine improves endothelial vasoreactivity and reduces thrombogenicity after thrombolysis in experimental deep venous thrombosis

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