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

IF 10.1 1区 工程技术 Q1 ENGINEERING, MULTIDISCIPLINARY Engineering Pub Date : 2024-11-01 DOI:10.1016/j.eng.2024.03.021
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
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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.
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旋转式血管内多方位超声导管用于声波溶栓:体外和体内研究
血管中的血栓栓塞如果处理不当,会带来中风、心脏病发作甚至猝死的严重风险。声波溶栓结合超声造影剂已成为有效治疗血栓栓塞的一种很有前景的方法。最近的报告强调了血管内超声溶栓作为一种安全有效的深静脉血栓(DVT)治疗方法的潜力。然而,其效率尚未通过对回缩血块的体内测试得到验证。本研究旨在开发一种微型化多向换能器,该换能器具有两个 4 层锆钛酸铅(PZT-5A)叠层,孔径大小为 1.4 毫米 × 1.4 毫米,可同时进行正视和侧视治疗。该设备与定制的双腔 10 法分(Fr)导管集成,其血管内超声溶栓能力在体外和体内均得到了验证。在体外测试中,使用低剂量组织浆细胞酶原激活剂和纳米微滴,旋转式多向换能器可在 30 分钟内将回缩的血凝块(800 毫克)平均减少 52%。与不旋转的前视换能器相比,溶解率明显提高了 37%。这一改进在治疗回缩血块方面尤为明显。值得注意的是,在猪深静脉血栓模型中,通过创建直径为 4 毫米的流道,在 40 分钟内成功治疗了一个长期回缩的血栓(10 厘米)。总之,这些研究结果有力地证明了这项技术在声波溶栓临床应用中的潜力,为有效治疗血栓栓塞提供了可行的解决方案,尤其是在涉及回缩血块的高难度病例中。
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来源期刊
Engineering
Engineering Environmental Science-Environmental Engineering
自引率
1.60%
发文量
335
审稿时长
35 days
期刊介绍: Engineering, an international open-access journal initiated by the Chinese Academy of Engineering (CAE) in 2015, serves as a distinguished platform for disseminating cutting-edge advancements in engineering R&D, sharing major research outputs, and highlighting key achievements worldwide. The journal's objectives encompass reporting progress in engineering science, fostering discussions on hot topics, addressing areas of interest, challenges, and prospects in engineering development, while considering human and environmental well-being and ethics in engineering. It aims to inspire breakthroughs and innovations with profound economic and social significance, propelling them to advanced international standards and transforming them into a new productive force. Ultimately, this endeavor seeks to bring about positive changes globally, benefit humanity, and shape a new future.
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