Effectiveness Of Transcranial And Transthoracic Ultrasound And Microbubbles In Dissolving Intravascular Thrombi

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Journal Of Ultrasound In Medicine


Objective. To examine the effectiveness of 1-MHz and 40-kHz ultrasound with and without microbubbles in fragmenting thrombi in attenuated conditions. Methods. First, an vitro transcranial model was used to examine the ability of these frequencies to-fragment thrombi in the presence or absence of perfluorocarbon-exposed sonicated dextrose albumin microbubbles. Second, an in vivo transthoracic model was used to test the effectiveness of these same frequencies with intravenous perfluorocarbon-exposed sonicated dextrose albumin in fragmenting left circumflex coronary thrombotic occlusions. Results. In the in vitro model, both transcranial 1-MHz and 40-kHz ultrasonic frequencies were effective at fragmenting thrombi only in the presence of microbubbles. In the in vivo model, 1-MHz ultrasound with intravenous perfluorocarbon-exposed sonicated dextrose albumin angiographically recanalized only 4 of 14 occlusions but was consistently effective at improving myocardial blood flow to the risk area even in the absence of angiographic recanalization. Both 40-kHz and 1-MHz ultrasound with perfluorocarbon-exposed sonicated dextrose albumin improved regional wall-thickening and electrocardiographic abnormalities (P < .05 compared with control or ultrasound alone). Conclusions. Transcranial and transthoracic ultrasound in the presence of Intravenous microbubbles can improve flow to Ischemic regions and should be considered as a supplement to current pharmacologic therapy.