Ultrasonic thrombolysis: catheter-delivered and transcutaneous applications

Atar, Shaul; Luo, Hao; Nagai, Tomoo; Siegel, Robert J.

doi:10.1016/s0929-8266(99)00007-5

Cited by 50 publications

(42 citation statements)

References 28 publications

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“…For porous materials, such as graphite, cavitation erosion is a significant contributor to material removal. Available evidence supports similar mechanisms in biological tissues (Cimino, 1999;Atar et al, 1999). All these mechanisms are directly related to the distal-tip displacement, amplitude and frequency (Fig.…”

Section: Introductionsupporting

confidence: 59%

High-power low-frequency ultrasound: A review of tissue dissection and ablation in medicine and surgery

OʼDaly

Morris

Gavin³

et al. 2008

Journal of Materials Processing Technology

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Ab s t r a c t High-power low-frequency ultrasound in the range 20-60 kHz has wide ranging clinical applications in surgical and medical instruments for biological tissue cutting, ablation or fragmentation, and removal. Despite widespread clinical application and common device operating characteristics, there is an incomplete understanding of the mechanism of tissue failure, removal and damage. The relative contribution of cavitation, direct mechanical impact and thermal effects to each process for specific tissue types remains unclear. Different and distinct mechanisms and rates of tissue removal are observed for interaction with soft and hard tissue types. Device operating parameters known to affect the interaction include frequency, peak-peak tip amplitude, suction and application time. To date, there has been little analysis of the effect of variations in, and interactions of, these parameters on tissue removal and damage for individual biological tissue types. Potential controllable damage mechanisms occurring in tissues include alteration in global biomechanical properties, histomorphological changes, protein denaturation and tissue necrosis. This paper presents a critical review of the literature on the clinical application, mechanism of tissue interaction, removal and residual tissue damage. It describes known mechanisms for distinct tissue types.

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Section: Introductionsupporting

confidence: 59%

High-power low-frequency ultrasound: A review of tissue dissection and ablation in medicine and surgery

OʼDaly

Morris

Gavin³

et al. 2008

Journal of Materials Processing Technology

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“…However, if the medium is liquid (i.e., blood) and can move under pressure, then such pressure can induce streaming with speeds of up to 6 m/s (37). This effect has important implications in sonotrombolysis, in which a clotdissolving agent is driven by streaming towards and inside the clot blocking a vessel (38).…”

Section: Radiation Force and Streamingmentioning

confidence: 99%

HIFU for Palliative Treatment of Pancreatic Cancer

Khokhlova

Hwang

2016

Advances in Experimental Medicine and Biology

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KEY WORDSHigh intensity focused ultrasound (HIFU) is a novel non-invasive modality for ablation of various solid tumors including uterine fibroids, prostate cancer, hepatic, renal, breast and pancreatic tumors. HIFU therapy utilizes mechanical energy in the form of a powerful ultrasound wave that is focused inside the body to induce thermal and/or mechanical effects in tissue. Multiple preclinical and non-randomized clinical trials have been performed to evaluate the safety and efficacy of HIFU for palliative treatment of pancreatic tumors. Substantial tumor-related pain reduction was achieved in most cases after HIFU treatment, and no significant side-effects were observed. This review provides a description of different physical mechanisms underlying HIFU therapy, summarizes the clinical experience obtained to date in HIFU treatment of pancreatic tumors, and discusses the challenges, limitations and new approaches in this modality. therapeutic ultrasound; focused ultrasound; HIFU; pancreas cancer; review J Gastrointest Oncol 2011; 2: 175-184.

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“…Acoustic streaming and pressure wave components may also contribute to the hard tissue disruption [4]. The ablation mechanisms for soft tissue disruption, however, are less well known.…”

Section: Introductionmentioning

confidence: 99%

Soft tissue cutting with ultrasonic mechanical waveguides

Wylie¹,

McGuinness²,

Gavin³

2012

AIP Conference Proceedings

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Abstract. The use of ultrasonic vibrations transmitted via small diameter wire waveguides represents a technology that has potential for minimally invasive procedures in surgery. This form of energy delivery results in distal tip mechanical vibrations with amplitudes of vibration of up to 50 µm and at frequencies between 20-50 kHz commonly reported. This energy can then be used by micro-cutting surgical tools and end effectors for a range of applications such as bone cutting, cement removal in joint revision surgery and soft tissue cutting. One particular application which has gained regulatory approval in recent years is in the area of cardiovascular surgery in the removal of calcified atherosclerotic plaques and chronic total occlusions. This paper builds on previous work that was focused on the ultrasonic perforation of soft vascular tissue using ultrasonically activated mechanical waveguides and the applied force required to initiate failure in soft tissue when compared with non-ultrasonic waveguides. An ultrasonic device and experimental rig was developed that can deliver ultrasonic vibrations to the distal tip of 1.0 mm diameter nickel-titanium waveguides. The operation of the ultrasonic device has been characterized at 22.5 kHz with achievable amplitudes of vibration in the range of 16 -40µm. The experimental rig allows the ultrasonically activated waveguide to be advanced through a tissue sample over a range of feedrates and the waveguide-tissue interaction force can be measured during perforation into the tissue. Preliminary studies into the effects of feedrate on porcine aortic arterial tissue perforation forces are presented as part of this work. A range of amplitudes of vibration at the wire waveguide distal tip were examined. The resulting temperature increase when perforating artery wall when using the energized wire waveguides is also examined. Results show a clear multistage failure of the tissue. The first stage involves a rise in force up to some critical force and tissue displacement whereby the cut is initiated. The results show that with increasing ultrasonic amplitude of vibration the perforation force decreases considerably. The current results show that for the range of feedrates investigated 19-95 mm/min at an amplitude of vibration of 34.3 µm there was no significant effect on the perforation initiation force. The ΔT in the tissue 3.0 mm from the point of entry is also presented for a range of amplitudes of vibration.

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Ultrasonic thrombolysis: catheter-delivered and transcutaneous applications

Cited by 50 publications

References 28 publications

High-power low-frequency ultrasound: A review of tissue dissection and ablation in medicine and surgery

High-power low-frequency ultrasound: A review of tissue dissection and ablation in medicine and surgery

HIFU for Palliative Treatment of Pancreatic Cancer

Soft tissue cutting with ultrasonic mechanical waveguides

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