Treatment of Acute Intravascular Thrombi With Diagnostic Ultrasound and Intravenous Microbubbles

Xie, Feng; Lof, John; Everbach, E. Carr; He, Anming; Bennett, Richard; Matsunaga, Terry O.; Johanning, Jason M.; Porter, Thomas R.

doi:10.1016/j.jcmg.2009.02.002

Cited by 74 publications

(58 citation statements)

References 4 publications

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“…Multiple animal studies have demonstrated that ultrasound in combination with microbubbles can recanalize acute intravascular thrombi in large vessels, including the iliofemoral arteries, 18,19 arteriovenous grafts, 20,21 central venous catheters, 22 coronary arteries, 23 and intracranial arteries, 24,25 underlining the potential of the treatment for dissolving microvascular thrombi. However, data on the effects of ultrasound and microbubble (US+MB) treatment on the thrombolysis of microthrombi are lacking, and it is unclear whether US+MB treatment may improve the outcomes of acute ischemic stroke induced by cerebral microthrombi.…”

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confidence: 99%

Microbubble-Mediated Sonothrombolysis Improves Outcome After Thrombotic Microembolism-Induced Acute Ischemic Stroke

Wang

Huang

et al. 2016

Stroke

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Microbubble-mediated sonothrombolysis is a promising treatment for cerebral microthrombi and is based on ultrasound driven cavitation of microbubbles that accelerate thrombolysis via localized mechanical stress on the thrombi. 17Background and Purpose-Microthrombi originating from disintegrated clots or formed in situ may account for the poor clinical improvement of acute ischemic stroke after recanalization therapy. We attempted to determine whether microbubble-mediated sonothrombolysis could dissolve platelet-rich and erythrocyte-rich microthrombi, thereby reducing their brain injury-causing potential. Methods-Platelet-and erythrocyte-rich microthrombosis were induced by periadventitial application of 5% ferric chloride or thrombin to mesenteric microvessels in 75 Sprague-Dawley rats. Acute ischemic stroke was induced by intracarotid injection of platelet-or erythrocyte-rich microthrombi in another 50 rats. Rats were randomly divided into control (CON), ultrasound (US), ultrasound and microbubble (US+MB), recombinant tissue-type plasminogen activator (r-tPA), and US+MB+r-tPA groups. The post-treatment mesenteric microvessel recanalization rates, cerebral infarct volumes, and neurological scores were determined. Results-The recanalization rates of platelet-and erythrocyte-rich microthrombi in mesenteric microvessels were higher (P<0.05), and the cerebral infarct volumes and neurological scores of rats with either microthrombi were lower in the US+MB group than in the CON group (P<0.01). The infarct volumes and neurological scores were greater in the r-tPA group than in the US+MB and US+MB+r-tPA groups after treatment of rats with platelet-rich microthrombi (P<0.05).In contrast, after treatment of rats with erythrocyte-rich microthrombi, the infarct volumes and neurological scores were similar in the r-tPA and US+MB groups, but smaller in the US+MB+r-tPA group (P<0.05). Conclusions-Microbubble-mediated sonothrombolysis improved the outcomes of microthrombi-induced acute ischemic stroke. Thus, this method may serve as an attractive adjunct to recanalization therapy for acute ischemic stroke.

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confidence: 99%

Microbubble-Mediated Sonothrombolysis Improves Outcome After Thrombotic Microembolism-Induced Acute Ischemic Stroke

Wang

Huang

et al. 2016

Stroke

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“…UCAs such as microbubbles have proved effective in curing intravascular thrombus [4]. Kaneko et al disclosed that high-intensity focused ultrasound associated with UCAs could be used in the liver treatment [5].…”

Section: Introductionmentioning

confidence: 99%

Advanced Microbubbles as a Multifunctional Platform Combining Imaging and Therapy

Wang

et al. 2016

Applied Sciences

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Microbubbles as traditional ultrasound contrast agents have seen tremendous developments and bio-applications in the past decades. Due to their outstanding performance, advanced microbubbles as a multifunctional platform combining both imaging and therapy have been increasingly attracting attention. Associated with ultrasound-mediated stimuli, targeting drug transportation with high precision can be established and, as a consequence, a synergistic treatment strategy may prevail, which implies a bright perspective for this brand-new technology. This perspective article will summarize the latest developments on the advanced microbubbles, and review their emerging biomedical applications for the vast community of both applied ultrasound and functional ultrasound-based materials.

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“…Low-frequency ultrasound and microbubble have been shown to accelerate thrombolysis in vitro and in vivo. 14,15 In addition, low frequency ultrasound has also been effective for suppressing tumour proliferation and for promoting tumour apoptosis.…”

Section: Introductionmentioning

confidence: 99%

Effects of low-frequency ultrasound combined with microbubbles on benign prostate hyperplasia

Yang

Tang²,

Bai

et al. 2013

CUAJ

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Introduction: Our objective is to assess the effects of low-frequency ultrasound combined with microbubbles on benign prostate hyperplasia (BPH). Methods: Sixteen Beagle dogs with BPH were randomly assigned into 4 groups (n = 4): control group (without treatment), G1 group (injection with 2 mL of microbubble contrast agent); G2 group (21 kHz ultrasound); and G3 group (injection with 2 mL of microbubble contrast agent +21 kHz ultrasound). The histopathological damage to prostate cells was assessed via transmission electron microscopy and optical microscopy. The protein expressions of prostate-specific antigen (PSA), inducible nitric oxide synthase (iNOS), superoxide dismutase (SOD) of vessels were detected by enzyme-linked immunosorbent assay (ELISA). Results: Histopathologically, the prostate cells exhibited nuclear chromatin contraction, mitochondrial swelling, degranulation of rough endoplasmic reticulum, basement membrane rupture and cell apoptosis in the G2 and G3 groups; it was especially obvious in the G3 group, while no changes were observed in the control and G1 groups. Although prostate volume using imaging was not significantly changed in all groups after treatment, PSA was significantly reduced in the G2 and G3 groups, and especially obvious in the G3 group (p < 0.05). The iNOS and SOD, which are important oxidative stress factors, significantly increased after treatment in the G2 and G3 groups, but not in the control and G1 groups (p < 0.05). Conclusions: Low-frequency ultrasound is effective in treating BPH; low-frequency ultrasound combined with microbubbles improves the treatment efficacy. IntroductionBenign prostatic hyperplasia (BPH) is a non-malignant enlargement of the prostate, ranking among the 10 most common diseases in aging men.1 BPH is characterized by smooth muscle and epithelial proliferation primarily within the prostatic transition zone, which results in a variety of problems for patients. The most frequent problem is lower urinary tract symptoms (LUTS) 2 and 80% of men in their 70s suffer from BPH-related LUTS. 3,4 Currently, the management of BPH involves non-surgical and surgical techniques. Alpha-blockers and 5-alpha reductase inhibitors are common medical options due to their excellent efficacy and convenience of administering without severe adverse effects. 5,6 Although transurethral resection of the prostate (TURP) is the gold standard for BPHrelated LUTS, it has disadvantages. Its potential disadvantages include significant blood loss and operative hyponatraemia, need for hospitalization and possible prolonged catheterization, and low, but real, risks of urinary incontinence, erectile dysfunction, bladder neck contractures, and urethral stricture disease.7 Laser surgery as a substitute has also been attempted and has a satisfactory short-term efficacy. [8][9][10] However, elderly and more infirm patients are least likely to undergo it; this raises concern about the underutilization of the technique in this population.11 Therefore, a more effective, safe, and easy trea...

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Treatment of Acute Intravascular Thrombi With Diagnostic Ultrasound and Intravenous Microbubbles

Cited by 74 publications

References 4 publications

Microbubble-Mediated Sonothrombolysis Improves Outcome After Thrombotic Microembolism-Induced Acute Ischemic Stroke

Microbubble-Mediated Sonothrombolysis Improves Outcome After Thrombotic Microembolism-Induced Acute Ischemic Stroke

Advanced Microbubbles as a Multifunctional Platform Combining Imaging and Therapy

Effects of low-frequency ultrasound combined with microbubbles on benign prostate hyperplasia

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