Transcutaneous ultrasound-facilitated coronary thrombolysis during acute myocardial infarction

Cohen, Mauricio G.; Tuero, Enrique; Blüguermann, Jorge; Kevorkián, Rubén; Berrocal, Daniel; Carlevaro, Oscar; Picabea, Eduardo; Hudson, Michael; Siegel, Robert J.; Douthat, Lori; Greenbaum, Adam; Echt, Debra S.; Weaver, W. Douglas; Grinfeld, Liliana

doi:10.1016/s0002-9149(03)00666-0

Cited by 53 publications

(33 citation statements)

References 12 publications

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“…Extracorporeal ultrasound has been combined with thrombolytic drugs in clinical trials to treat both acute myocardial infarction [26] and acute middle cerebral artery stroke [27] with promising results. However, both of these treatment methods require further validation and optimisation.…”

Section: Discussionmentioning

confidence: 99%

Pulsed-high intensity focused ultrasound enhanced tPA mediated thrombolysis in a novel in vivo clot model, a pilot study

Frenkel

Dromi

et al. 2007

Thrombosis Research

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Introduction-Thrombotic disease continues to account for significant morbidity and mortality. Ultrasound energy has been investigated as a potential primary and adjunctive treatment for thrombotic disease. We have previously shown that pulsed-high intensity focused ultrasound (HIFU) enhances thrombolysis induced by tissue plasminogen activator (tPA) in vitro, including describing the non-destructive mechanism by which tPA availability and consequent activity is increased. In this study we aimed to determined if the same effects could be achieved in vivo.

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Section: Discussionmentioning

confidence: 99%

Pulsed-high intensity focused ultrasound enhanced tPA mediated thrombolysis in a novel in vivo clot model, a pilot study

Frenkel

Dromi

et al. 2007

Thrombosis Research

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“…Therapeutic transcutaneous ultrasound has been investigated as an adjunct to intravenously administered thrombolytic drug therapy in an attempt to improve these outcomes [13,14], however recent human clinical trials using this technique in ST elevation myocardial infarction (PLUS Trial [unpublished data, 2003]), and acute ischemic stroke (TRUMBI Trial [15]), have failed to show efficacy or safety, probably due to the problematic high attenuation characteristics of the therapeutic ultrasound through lung or bone [16,17] plus ultrasound's propensity, especially at higher intensities, to lead to increased platelet adhesion [18], damage blood vessels [19][20][21][22][23][24] and burn the overlying skin of patients receiving therapy [22,23].…”

Section: Introductionmentioning

confidence: 99%

Non-invasive low frequency vibration as a potential emergency adjunctive treatment for heart attack and stroke. An in vitro flow model

Yohannes

Hoffmann

2007

J Thromb Thrombolysis

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The frequent and generally rapid re-establishment of flow in vibration groups compared to the complete absence of reflow in control groups confirms the hypothesis that vibration applied across a physical barrier assists clearance of a blood clot in a stenosed flow system under systemic levels of pressure. We studied the incidence of clearance of a blood clot within a stenosed, heparanized catheter system held at arterial like pressure that was treated with externally delivered low frequency vibration (applied proximate the thrombotic occlusion across an attenuating medium--a 2 cm thick slab of New York Steak--at approximately 100 Hz, 0.5 mm), versus no vibration. Reflow in test runs incorporating vibration occurred faster, and resulted in significantly greater recanulization rates in the catheter system versus test runs without vibration (P=0.0000009). Non-invasive vibration holds potential as an adjunct to pharmacologic therapy in treatment of acute arterial thrombosis. Further study of this technique appears warranted in live animal models.

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“…Recent clinical studies have demonstrated improved thrombolysis with the concomitant use of focused ultrasound and a thrombolytic agent for stroke and acute myocardial infarction [2][3][4]. Suggested mechanisms include acoustic streaming which promotes transport of drugs into the thrombus, radiation force which might facilitate reformation and opening of the fibrin matrix enhancing drug diffusion, cleaving of fibrin polymers to extend the surface for drug interaction, and direct effects on binding of the agent to fibrin [5].…”

mentioning

confidence: 99%

Ultrasound-facilitated thrombolysis using tissue-plasminogen activator-loaded echogenic liposomes

Tiukinhoy-Laing¹,

Huang²,

Klegerman³

et al. 2007

Thrombosis Research

122

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Introduction-Targeted delivery of thrombolytics to the site of occlusion is an attractive concept, with implications for the treatment of many thrombo-occlusive diseases. Ultrasound enhances thrombolysis, which can be augmented by the addition of a contrast agent. We have previously reported development of echogenic liposomes (ELIP) for targeted highlighting of structures with potential for drug and gene delivery. This study evaluated the potential of ELIP for thrombolytic loading, and the effect of ultrasound exposure of thrombolytic-loaded ELIP on thrombolytic efficacy.

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Transcutaneous ultrasound-facilitated coronary thrombolysis during acute myocardial infarction

Cited by 53 publications

References 12 publications

Pulsed-high intensity focused ultrasound enhanced tPA mediated thrombolysis in a novel in vivo clot model, a pilot study

Pulsed-high intensity focused ultrasound enhanced tPA mediated thrombolysis in a novel in vivo clot model, a pilot study

Non-invasive low frequency vibration as a potential emergency adjunctive treatment for heart attack and stroke. An in vitro flow model

Ultrasound-facilitated thrombolysis using tissue-plasminogen activator-loaded echogenic liposomes

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