Ultrasound and Intra-Clot Microbubbles Enhanced Catheter-Directed Thrombolysis in Vitro and in Vivo

Ultrasound Med Biol. 2017 Aug;43(8):1671-1678. doi: 10.1016/j.ultrasmedbio.2017.03.017. Epub 2017 May 4.

Abstract

Insufficient penetration of microbubbles (MBs) into the vessel-obstructing thrombi significantly reduces the effectiveness of ultrasound thrombolysis (UT). The widely performed catheter-directed therapy (CDT) makes it possible to increase the local concentration of MBs in the clot. In an occluded vessel with a bypass, treatment of fresh human whole blood clots with CDT-based UT (intra-clot injection of MBs and urokinase, with ultrasound exposure) resulted in a significantly higher percentage of weight loss (35.32 ± 15.42%), compared with CDT alone (19.64 ± 4.71%), non-CDT-based UT (systemic administration of urokinase and MBs, with ultrasound exposure, 8.79 ± 3.02%) and systemic thrombolysis (7.90 ± 2.14). Ultrasound and intra-clot MB enhancement of CDT was further confirmed by a rabbit IVC thrombolysis study, where CDT-based UT resulted in significantly more effective thrombolysis compared with CDT alone. In summary, combining CDT with intra-clot MB-induced acoustic cavitation can improve thrombolysis.

Keywords: Catheter-directed technique; Microbubbles; Thrombolysis; Ultrasound.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Catheters
  • Contrast Media*
  • Image Enhancement / methods*
  • In Vitro Techniques
  • Microbubbles*
  • Rabbits
  • Thrombosis / diagnostic imaging
  • Thrombosis / therapy
  • Ultrasonic Therapy / instrumentation*
  • Ultrasonic Therapy / methods*
  • Ultrasonography, Interventional / methods*

Substances

  • Contrast Media