Histotripsy Liquefaction of Large Hematoma for Intracerebral Hemorrhage Using Millisecond-Length Ultrasound Pulse Groups Combined With Fundamental and Second Harmonic Superposition: A Preliminary Study

On-demand regulation and enhancement of the nucleation in acoustic droplet vaporization using dual-frequency focused ultrasound

“…Dual- or multiple-frequency ultrasound is also effective to reduce the cavitation threshold or increase cavitation effects compared with standard single-frequency ultrasound. Dual-frequency excitation was utilized for cavitation-enhanced thermal ablation [21] , thrombolysis [22] , [23] , [24] , and sonodynamic therapy [25] , and was able to reduce the inertial cavitation threshold and improve therapeutic efficiency significantly. Numerical studies suggested the potential mechanisms for enhanced bubble cavitation by dual-frequency excitation, which include the unique nonlinear features of superharmonic focusing [26] , bubble oscillations [27] , the enhancement of the bubble expansion ratio and collapse strength [28] , the reduction of inertial cavitation threshold [29] , the increase mass transfer through the bubble interface [30] and the alteration of the bubble spherical stability [31] .…”

Histotripsy: the first noninvasive, non-ionizing, non-thermal ablation technique based on ultrasound

“…Within a bulk tissue, boiling bubble formation does not always lead to jetting, while recirculation of the fountain projectiles within the treatment volume is necessary for complete tissue homogenization. Boiling histotripsy causes similar bioeffects as histotripsy and has been investigated for the treatment of tumors in the liver [ 40 ] and kidney [ 43 ] as well as large hematomas [ 52 , 54 ].…”

“…The non-thermal nature also enables histotripsy to overcome many of the limitations associated with thermal devices (e.g., heat sink effect, lack of precise margins, and predictability). Histotripsy has been investigated for many pre-clinical applications, including treatment for tumors in the liver [37][38][39][40][41], kidney [23,40,42,43], and prostate [44,45], neurological diseases [46,47], thrombosis [48][49][50][51], hematoma [52][53][54], neonatal and fetal congenital heart disease [17,55], valvular diseases [56,57], kidney stones [58], abscesses [59], tendons [60], and biofilms [61][62][63]. Phase I human trials have been undertaken for histotripsy treatment of benign prostatic hyperplasia [64], liver cancer, and calcified valve stenosis [65], with early results suggesting safety and feasibility in humans.…”

Research progress and clinical evaluation of histotripsy: a narrative review

“…M a s s i v e i n t r a a b d o m i n a l , r e t r o p e r i t o n e a l , a n d intramuscular hematomas can place enormous pressure on surrounding tissues, leading to serious complications, including infection, organ failure, and amputation (114,115). Currently, the treatment of massive hematoma mainly includes drainage and surgery (116). However, the drainage effect of acute blood clots is often poor, and surgical treatment may also lead to risks of recurrence, infection, and intraoperative accidents (116).…”

“…Currently, the treatment of massive hematoma mainly includes drainage and surgery ( 116 ). However, the drainage effect of acute blood clots is often poor, and surgical treatment may also lead to risks of recurrence, infection, and intraoperative accidents ( 116 ). Some research teams ( 117 , 118 ) proposed that boiling histotripsy could be used to liquefy the hematoma and make it amenable to being drained out of the body.…”