Non-Invasive Thrombolysis Using Microtripsy in a Porcine Deep Vein Thrombosis Model |
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Authors: | Xi Zhang Jonathan J. Macoskey Kimberly Ives Gabe E. Owens Hitinder S. Gurm Jiaqi Shi Matthew Pizzuto Charles A. Cain Zhen Xu |
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Affiliation: | 1. Department of Biomedical Engineering, University of Michigan, Ann Arbor, Michigan, USA;2. Department of Pediatrics and Communicable Diseases, University of Michigan, Ann Arbor, Michigan, USA;3. Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, USA;4. Department of Pathology, University of Michigan, Ann Arbor, Michigan, USA |
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Abstract: | Histotripsy is a non-invasive therapeutic technique that uses ultrasound generated from outside the body to create controlled cavitation in targeted tissue, and fractionates it into acellular debris. We have developed a new histotripsy approach, termed microtripsy, to improve targeting accuracy and to avoid collateral tissue damage. This in vivo study evaluates the safety and efficacy of microtripsy for non-invasive thrombolysis in a porcine deep vein thrombosis model. Acute thrombi were formed in left femoral veins of pigs (~35 kg) by occluding the vessel using two balloon catheters and infusing with thrombin. Guided by real-time ultrasound imaging, microtripsy thrombolysis treatment was conducted in 14 pigs; 10 pigs were euthanized on the same day (acute) and 4 at 2 wk (subacute). To evaluate vessel damage, 30-min free-flow treatment in the right femoral vein (no thrombus) was also conducted in 8 acute pigs. Blood flow was successfully restored or significantly increased after treatment in 13 of the 14 pigs. The flow channels re-opened by microtripsy had a diameter up to 64% of the vessel diameter (~6 mm). The average treatment time was 16 min per centimeter-long thrombus. Only mild intravascular hemolysis was induced during microtripsy thrombolysis. No damage was observed on vessel walls after 2 wk of recovery, venous valves were preserved, and there was no sign of pulmonary embolism. The results of this study indicate that microtripsy has the potential to be a safe and effective treatment for deep vein thrombosis in a porcine model. |
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Keywords: | Histotripsy Microtripsy Thrombolysis Sonothrombolysis Deep vein thrombosis |
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