用于溶栓的旋转式血管内多方向超声导管——体外和体内研究

Huaiyu Wu; Jinwook Kim; Bohua Zhang; Gabe Owens; Greyson Stocker; Mengyue Chen; Benjamin C. Kreager; Ashley Cornett; Kathlyne Bautista; Tarana Kaovasia; Paul A. Dayton; Zhen Xu; Xiaoning Jiang

doi:10.1016/j.eng.2024.03.021

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工程（英文） ›› 2024, Vol. 42 ›› Issue (11) : 235-243. DOI: 10.1016/j.eng.2024.03.021

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用于溶栓的旋转式血管内多方向超声导管——体外和体内研究

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Rotational Intravascular Multidirectional Ultrasound Catheter for Sonothrombolysis of Retracted Clots: An in Vitro and in Vivo Study

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Abstract

Thromboembolism in blood vessels poses a serious risk of stroke, heart attack, and even sudden death if not properly managed. Sonothrombolysis combined with ultrasound contrast agents has emerged as a promising approach for the effective treatment of thromboembolism. Recent reports have highlighted the potential of intravascular sonothrombolysis as a safe and effective treatment modality for deep vein thrombosis (DVT). However, its efficiency has not been validated through in vivo testing of retracted clots. This study aimed to develop a miniaturized multidirectional transducer featuring two 4-layer lead zirconate titanate (PZT-5A) stacks with an aperture size of 1.4 mm × 1.4 mm, enabling both forward- and side-looking treatment. Integrated into a custom two-lumen 10-French (Fr) catheter, the capability of this device for intravascular sonothrombolysis was validated both in vitro and in vivo. With low-dose tissue plasminogen activators and nanodroplets, the rotational multidirectional transducer reduced the retracted clot mass (800 mg) by an average of 52% within 30 min during in vitro testing. The lysis rate was significantly higher by 37% than that in a forward-viewing transducer without rotation. This improvement was particularly noteworthy in the treatment of retracted clots. Notably, a long-retracted clot (> 10 cm) was successfully treated within 40 min in vivo by creating a flow channel with a diameter > 4 mm in a porcine DVT model. In conclusion, these findings strongly suggest the potential of this technique for clinical applications in sonothrombolysis, offering a feasible solution for effectively treating thromboembolism, particularly in challenging cases involving retracted clots.

Keywords

Intravascular ultrasound catheter / Sonothrombolysis in vivo / Retracted clots thrombolysis

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Huaiyu Wu, Jinwook Kim, Bohua Zhang. 用于溶栓的旋转式血管内多方向超声导管——体外和体内研究. Engineering. 2024, 42(11): 235-243 https://doi.org/10.1016/j.eng.2024.03.021

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