Sonothrombolysis of intra-catheter aged venous thrombi using microbubble enhancement and guided three-dimensional ultrasound pulses

Shelby Kutty, Feng Xie, Shunji Gao, Lucas K. Drvol, John Lof, Scott E. Fletcher, Stanley J Radio, David Alan Danford, James M Hammel, Thomas Richard Porter

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

Background: Central venous and arterial catheters are a major source of thromboembolic disease in children. The investigators hypothesized that guided high-mechanical index (MI) impulses from diagnostic three-dimensional (3D) ultrasound during an intravenous microbubble infusion could dissolve these thrombi. Methods: An in vitro system simulating intracatheter thrombi was created and then treated with guided high-MI impulses from 3D ultrasound, using low-MI microbubble sensitive imaging pulse sequence schemes to detect the microbubbles. Ten aged thrombi >24 hours old were tested using 3D ultrasound coupled with a continuous diluted microbubble infusion (group A) and 10 with 3D ultrasound alone (group B). Results: The mean thrombus age was 28.6 hours (range, 26.6-30.3 hours). Group A exhibited a 55 ± 19% reduction in venous thrombus size compared with 31 ± 10% in group B (P = .008). Feasibility testing was performed in four pigs, establishing an in vivo model to investigate further the efficacy of this approach. Conclusions: Sonothrombolysis of aged intracatheter venous thrombi can be achieved with commercially available microbubbles and guided high-MI ultrasound from a diagnostic 3D transducer.

Original languageEnglish (US)
Pages (from-to)1001-1006
Number of pages6
JournalJournal of the American Society of Echocardiography
Volume23
Issue number9
DOIs
StatePublished - Sep 1 2010

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Microbubbles
Thrombosis
Catheters
Central Venous Catheters
Transducers
Intravenous Infusions
Ultrasonography
Swine
Research Personnel

Keywords

  • Microbubble
  • Pediatric
  • Sonothrombolysis
  • Three-dimensional echocardiography

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

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title = "Sonothrombolysis of intra-catheter aged venous thrombi using microbubble enhancement and guided three-dimensional ultrasound pulses",
abstract = "Background: Central venous and arterial catheters are a major source of thromboembolic disease in children. The investigators hypothesized that guided high-mechanical index (MI) impulses from diagnostic three-dimensional (3D) ultrasound during an intravenous microbubble infusion could dissolve these thrombi. Methods: An in vitro system simulating intracatheter thrombi was created and then treated with guided high-MI impulses from 3D ultrasound, using low-MI microbubble sensitive imaging pulse sequence schemes to detect the microbubbles. Ten aged thrombi >24 hours old were tested using 3D ultrasound coupled with a continuous diluted microbubble infusion (group A) and 10 with 3D ultrasound alone (group B). Results: The mean thrombus age was 28.6 hours (range, 26.6-30.3 hours). Group A exhibited a 55 ± 19{\%} reduction in venous thrombus size compared with 31 ± 10{\%} in group B (P = .008). Feasibility testing was performed in four pigs, establishing an in vivo model to investigate further the efficacy of this approach. Conclusions: Sonothrombolysis of aged intracatheter venous thrombi can be achieved with commercially available microbubbles and guided high-MI ultrasound from a diagnostic 3D transducer.",
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author = "Shelby Kutty and Feng Xie and Shunji Gao and Drvol, {Lucas K.} and John Lof and Fletcher, {Scott E.} and Radio, {Stanley J} and Danford, {David Alan} and Hammel, {James M} and Porter, {Thomas Richard}",
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T1 - Sonothrombolysis of intra-catheter aged venous thrombi using microbubble enhancement and guided three-dimensional ultrasound pulses

AU - Kutty, Shelby

AU - Xie, Feng

AU - Gao, Shunji

AU - Drvol, Lucas K.

AU - Lof, John

AU - Fletcher, Scott E.

AU - Radio, Stanley J

AU - Danford, David Alan

AU - Hammel, James M

AU - Porter, Thomas Richard

PY - 2010/9/1

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N2 - Background: Central venous and arterial catheters are a major source of thromboembolic disease in children. The investigators hypothesized that guided high-mechanical index (MI) impulses from diagnostic three-dimensional (3D) ultrasound during an intravenous microbubble infusion could dissolve these thrombi. Methods: An in vitro system simulating intracatheter thrombi was created and then treated with guided high-MI impulses from 3D ultrasound, using low-MI microbubble sensitive imaging pulse sequence schemes to detect the microbubbles. Ten aged thrombi >24 hours old were tested using 3D ultrasound coupled with a continuous diluted microbubble infusion (group A) and 10 with 3D ultrasound alone (group B). Results: The mean thrombus age was 28.6 hours (range, 26.6-30.3 hours). Group A exhibited a 55 ± 19% reduction in venous thrombus size compared with 31 ± 10% in group B (P = .008). Feasibility testing was performed in four pigs, establishing an in vivo model to investigate further the efficacy of this approach. Conclusions: Sonothrombolysis of aged intracatheter venous thrombi can be achieved with commercially available microbubbles and guided high-MI ultrasound from a diagnostic 3D transducer.

AB - Background: Central venous and arterial catheters are a major source of thromboembolic disease in children. The investigators hypothesized that guided high-mechanical index (MI) impulses from diagnostic three-dimensional (3D) ultrasound during an intravenous microbubble infusion could dissolve these thrombi. Methods: An in vitro system simulating intracatheter thrombi was created and then treated with guided high-MI impulses from 3D ultrasound, using low-MI microbubble sensitive imaging pulse sequence schemes to detect the microbubbles. Ten aged thrombi >24 hours old were tested using 3D ultrasound coupled with a continuous diluted microbubble infusion (group A) and 10 with 3D ultrasound alone (group B). Results: The mean thrombus age was 28.6 hours (range, 26.6-30.3 hours). Group A exhibited a 55 ± 19% reduction in venous thrombus size compared with 31 ± 10% in group B (P = .008). Feasibility testing was performed in four pigs, establishing an in vivo model to investigate further the efficacy of this approach. Conclusions: Sonothrombolysis of aged intracatheter venous thrombi can be achieved with commercially available microbubbles and guided high-MI ultrasound from a diagnostic 3D transducer.

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