Intra-clot Microbubble-Enhanced Ultrasound Accelerates Catheter-Directed Thrombolysis for Deep Vein Thrombosis: A Clinical Study

Dong, Gang; Wang, Zhiwei; Sun, Lulu; Gao, Shunji; Lv, Zheng

doi:10.1016/j.ultrasmedbio.2019.04.022

Cited by 9 publications

(7 citation statements)

References 32 publications

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“…More commonly, ultrasound can be used to enhance thrombolysis, with ultrasound frequencies and intensities that do not induce thermal damage. 128 Ultrasound causes a decrease in the diameter of the fibers due to tension as a result of vibration, leading to increased binding sites for plasmin(ogen)/t-PA. 129 The positive feedback of this structural change together with increased mixing/transport of t-PA/plasmin(ogen) is likely to account for the observed enhancement of fibrinolysis by ultrasound. Now it is increasingly common for the use of a combination of thrombolysis and thrombectomy.…”

Section: Future Directionsmentioning

confidence: 99%

“…This novel technology is used to focus intense beams of ultrasound energy precisely and accurately on targets deep in the body to ablate a thrombus by thermal destruction without damaging surrounding normal tissue. More commonly, ultrasound can be used to enhance thrombolysis, with ultrasound frequencies and intensities that do not induce thermal damage 128 . Ultrasound causes a decrease in the diameter of the fibers due to tension as a result of vibration, leading to increased binding sites for plasmin(ogen)/t‐PA 129 .…”

Section: Future Directionsmentioning

confidence: 99%

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Visualizing thrombosis to improve thrombus resolution

Weisel

Litvinov

2021

Research and Practice in Thrombosis and Haemostasis

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The severity, course, and outcomes of thrombosis are determined mainly by the size and location of the thrombus, but studying thrombus structure and composition has been an important but challenging task. The substantial progress in determination of thrombus morphology has become possible due to new intravital imaging methodologies in combination with mechanical thrombectomy, which allows extraction of a fresh thrombus from a patient followed by microscopy. Thrombi have been found to contain various structural forms of fibrin along with platelet aggregates, leukocytes, and red blood cells, many of which acquire a polyhedral shape (polyhedrocytes) as a result of intravital platelet‐driven contraction. The relative volume fractions of thrombus components and their structural forms vary substantially, depending on the clinical and pathogenic characteristics. This review summarizes recent research that describes quantitative and qualitative morphologic characteristics of arterial and venous thrombi that are relevant for the pathogenesis, prophylaxis, diagnosis, and treatment of thrombosis.

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Section: Future Directionsmentioning

confidence: 99%

Section: Future Directionsmentioning

confidence: 99%

Visualizing thrombosis to improve thrombus resolution

Weisel

Litvinov

2021

Research and Practice in Thrombosis and Haemostasis

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“…Whereas Zhu et al did a clinical study on intra-clot microbubble-enhanced ultrasound thrombolysis for deep vein thrombosis. An average thrombolysis time was almost two times shorter and urokinase dosage was diminished with no complications whatsoever [46]. Targeted nanobubbles with ultrasound were also successfully used in the treatment of Alzheimer disease [47] and Parkinson's disease by ultrasound mediated plasmid delivery by DNA-loaded MBs complexes [48].…”

Section: Gliomamentioning

confidence: 99%

Microbubble based sonoporation — from the basics into clinical implications

Wawryka

Iwanek

2019

Medical Research Journal

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Sonoporation is a rapidly developing novel technique serving for drug delivery and non-viral gene therapy. It is based on the interaction between microbubbles located in the surrounding of a cell and its membrane. The interaction is obtained by excitation of microbubbles with ultrasounds. This leads to reversible cell membrane poration. Depending on the intensity of ultrasounds, structure of microbubbles used in an experiment and different environmental factors, microbubbles can interact in two manners. First, in lower ultrasound intensities, stable cavitation-regular microbubbles oscillations due to changes in the environment pressure. Microbubbles have to be very close to a cell membrane, therefore, they are usually targeted to an antigen located on the cell membrane by antibodies. Consequently, microbubbles push and pull on the cell membrane and create microstreaming around it causing its disruption. Second, inertial cavitation, where in contrary to the previous one, oscillations cause rapid collapse of microbubbles, which creates shock waves and microjets for the same purpose. No matter in which manner prorated, cells tend to reseal their disrupted cell membrane. Ca2+ ions play a crucial role in the process as well as endo exocytosis. Sonoporation has proved to be an effective modality against different diseases, including variety of cancer types in of both laboratory and clinical studies.

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“…Their size is similar to the average erythrocyte, meaning they remain within the endovascular borders during their travel from the site of injection to the site of interest. This feature has resulted in MBs also being investigated for a variety of focussed therapeutic purposes, as they can be 'burst' using higher US intensities once at the site of interest, creating localised biophysical disruptions in the vicinity [2,3], and if loaded with a treatment agent, delivering a localised therapeutic payload [4].…”

Section: Introductionmentioning

confidence: 99%