Microbubble-augmented ultrasound declotting of thrombosed arteriovenous dialysis grafts in dogs

William C. Culp, Thomas Richard Porter, Timothy C. McCowan, Paula K. Roberson, Charles A. James, W. Jean Matchett, Mohammed Moursi

Research output: Contribution to journalArticle

59 Citations (Scopus)

Abstract

PURPOSE: Transcutaneous low-frequency ultrasound (LFUS) can effectively lyse clots in the presence of microbubbles. This study was designed to test the commercially available human albumin microspheres injectable suspension octafluoropropane formulation, Optison, to establish efficacy and assess US parameters of intensity and wave modes in a canine model of a thrombosed arteriovenous (dialysis) graft. MATERIALS AND METHODS: Arteriovenous grafts in five dogs were cannulated, temporarily ligated, and thrombosed. Different declotting techniques were randomized to treat nine groups. Control groups involved direct saline (4.5 mL) clot injection in 0.5-1.0-mL increments. One group underwent peripheral intravenous microbubble injection (13.5 mL). Six groups underwent direct incremental clot injection of 4.5 mL of microspheres with LFUS for 30 minutes in 3-5-minute increments with use of various intensity settings in continuous-wave and pulsed-wave (PW) modes. At each increment, angiography was used to grade flow, declotting, and overall success. RESULTS: One hundred four procedures showed success in all 24 high-intensity PW modes (1.2-2.0 W/cm2); only one of 20 control experiments was successful (P < .0001). Medium-intensity modes yielded intermediate success rates. Lowest-intensity direct-injection groups and intravenous and control groups ranked lower. Results at 30 minutes were better than at 15 minutes (P < .0001). CONCLUSIONS: LFUS with direct injection of microbubbles is effective in lysing moderate-sized clots and recanalizing thrombosed arteriovenous grafts. It best succeeds at the higher range of intensity settings tested in PW mode. Further development is justified.

Original languageEnglish (US)
Pages (from-to)343-347
Number of pages5
JournalJournal of Vascular and Interventional Radiology
Volume14
Issue number3
DOIs
StatePublished - Mar 1 2003

Fingerprint

Microbubbles
Dialysis
Thrombosis
Dogs
Transplants
Injections
perflutren
Microspheres
Intravenous Injections
Control Groups
Canidae
Albumins
Suspensions
Angiography

Keywords

  • Dialysis
  • Grafts, stenosis or thrombosis
  • Microbubbles
  • Thrombosis, experimental
  • US, therapeutic

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

Microbubble-augmented ultrasound declotting of thrombosed arteriovenous dialysis grafts in dogs. / Culp, William C.; Porter, Thomas Richard; McCowan, Timothy C.; Roberson, Paula K.; James, Charles A.; Jean Matchett, W.; Moursi, Mohammed.

In: Journal of Vascular and Interventional Radiology, Vol. 14, No. 3, 01.03.2003, p. 343-347.

Research output: Contribution to journalArticle

Culp, William C. ; Porter, Thomas Richard ; McCowan, Timothy C. ; Roberson, Paula K. ; James, Charles A. ; Jean Matchett, W. ; Moursi, Mohammed. / Microbubble-augmented ultrasound declotting of thrombosed arteriovenous dialysis grafts in dogs. In: Journal of Vascular and Interventional Radiology. 2003 ; Vol. 14, No. 3. pp. 343-347.
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AB - PURPOSE: Transcutaneous low-frequency ultrasound (LFUS) can effectively lyse clots in the presence of microbubbles. This study was designed to test the commercially available human albumin microspheres injectable suspension octafluoropropane formulation, Optison, to establish efficacy and assess US parameters of intensity and wave modes in a canine model of a thrombosed arteriovenous (dialysis) graft. MATERIALS AND METHODS: Arteriovenous grafts in five dogs were cannulated, temporarily ligated, and thrombosed. Different declotting techniques were randomized to treat nine groups. Control groups involved direct saline (4.5 mL) clot injection in 0.5-1.0-mL increments. One group underwent peripheral intravenous microbubble injection (13.5 mL). Six groups underwent direct incremental clot injection of 4.5 mL of microspheres with LFUS for 30 minutes in 3-5-minute increments with use of various intensity settings in continuous-wave and pulsed-wave (PW) modes. At each increment, angiography was used to grade flow, declotting, and overall success. RESULTS: One hundred four procedures showed success in all 24 high-intensity PW modes (1.2-2.0 W/cm2); only one of 20 control experiments was successful (P < .0001). Medium-intensity modes yielded intermediate success rates. Lowest-intensity direct-injection groups and intravenous and control groups ranked lower. Results at 30 minutes were better than at 15 minutes (P < .0001). CONCLUSIONS: LFUS with direct injection of microbubbles is effective in lysing moderate-sized clots and recanalizing thrombosed arteriovenous grafts. It best succeeds at the higher range of intensity settings tested in PW mode. Further development is justified.

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