Ultrasound Imaging–Guided Noninvasive Ultrasound Thrombolysis

Rosenschein, Uri; Фурман, В.; Kerner, E.; Fabian, Itzchak; Bernheim, Joëlle; Eshel, Yoram

doi:10.1161/01.cir.102.2.238

Cited by 129 publications

(85 citation statements)

References 28 publications

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“…This increase was reduced when the fibrin gels were degassed, and thus these authors attributed the increase to cavitational activity. Other authors have shown that high intensity focused US produced echo-dense material in the clot, most probably by creating cavitation bubbles [134].…”

Section: Thrombolytic Enzymesmentioning

confidence: 99%

Ultrasonic drug delivery – a general review

Pitt

Husseini

Staples

2004

Expert Opinion on Drug Delivery

544

428

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Ultrasound (US) has an ever-increasing role in the delivery of therapeutic agents including genetic material, proteins, and chemotherapeutic agents. Cavitating gas bodies such as microbubbles are the mediators through which the energy of relatively non-interactive pressure waves is concentrated to produce forces that permeabilize cell membranes and disrupt the vesicles that carry drugs. Thus the presence of microbubbles enormously enhances delivery of genetic material, proteins and smaller chemical agents. Delivery of genetic material is greatly enhanced by ultrasound in the presence of microbubbles. Attaching the DNA directly to the microbubbles or to gas-containing liposomes enhances gene uptake even further. US-enhanced gene delivery has been studied in various tissues including cardiac, vascular, skeletal muscle, tumor and even fetal tissue. US-enhanced delivery of proteins has found most application in transdermal delivery of insulin. Cavitation events reversibly disrupt the structure of the stratus corneum to allow transport of these large molecules. Other hormones and small proteins could also be delivered transdermally. Small chemotherapeutic molecules are delivered in research settings from micelles and liposomes exposed to ultrasound. Cavitation appears to play two roles: it disrupts the structure of the carrier vesicle and releases the drug; it also makes the cell membranes and capillaries more permeable to drugs. There remains a need to better understand the physics of cavitation of microbubbles and the impact that such cavitation has upon cells and drug-carrying vesicles.

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Section: Thrombolytic Enzymesmentioning

confidence: 99%

Ultrasonic drug delivery – a general review

Pitt

Husseini

Staples

2004

Expert Opinion on Drug Delivery

544

428

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“…Этот эффект в первую очередь связан с эффектом нестацио-нарной кавитации, т.е. быстрым увеличением и коллап-сом микропузырьков [76,77].…”

Section: сонотромболизисunclassified

The use of transcranial focused ultrasound in CNS diseases

Galkin

2016

Vopr. neirokhir.

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Транскраниальный фокусированный ультразвук -это современная медицинская технология, которая позволяет неинва-зивно оказывать воздействие на головной мозг. Современный этап развития этой методики насчитывает не более 20 лет и многие возможные приложения технологии находятся только на этапе доклинических исследований. Наибольший про-гресс достигнут в области функциональной нейрохирургии: фокусированный ультразвук позволяет неинвазивно под постоянным контролем МРТ создавать небольшие очаги деструкции в соответствующих мишенях, обеспечивая лечебные нейромодулирующие эффекты при болезни Паркинсона, эссенциальном треморе, болевых синдромах, обсессивно-ком-пульсивных расстройствах и других заболеваниях. На настоящий момент данное лечение проведено более чем у 300 пациентов. Опубликованы единичные случаи ультразвуковой термодеструкции интракраниальных новообразований. На животных проводятся попытки проведения ультразвуковой третьей вентрикулостомии. Отдельное направление посвя-щено увеличению проницаемости гематоэнцефалического барьера для различных веществ под воздействием фокусиро-ванного ультразвука. В лабораториях исследуется возможность увеличения проницаемости для химиопрепаратов, иммун-ных препаратов и других веществ. Большое количество работ направлено на лечение болезни Альцгеймера. Начаты кли-нические исследования увеличения проницаемости гематоэнцефалического барьера для химиопрепаратов. Еще одним недеструктивным эффектом, который в настоящее время активно исследуется на животных, является способность фоку-сированного ультразвука оказывать обратимое нейромодулирующее -стимулирующее и ингибирующее -действие на структуры нервной системы. Также в лабораторных исследованиях продемонстрирована способность фокусированного ультразвука разрушать сгустки крови и тромбы. Транскраниальный фокусированный ультразвук представляет множество уникальных возможностей для научной и прак-тической медицинской деятельности. Широкому внедрению в клинику будет предшествовать большая исследовательская работа. Тем не менее уже сейчас можно утверждать, что внедрение этой технологии значительно расширит диагностиче-ские и лечебные возможности в нейрохирургии и неврологии. Ключевые слова: ультразвук, фокусированный ультразвук, нейрохирургия, функциональная нейрохирургия, гематоэнцефалический барьер. The use of transcranial focused ultrasound in CNS diseases M.V. GALKIN Burdenko Neurosurgical Institute, Moscow, RussiaTranscranial focused ultrasound is a modern medical technique, which provides non-invasive impact on the brain. Current development stage of this technique is no longer than 20 years and many possible applications of this technique are still at preclinical stage. The greatest progress has been made in the field of functional neurosurgery. Focused ultrasound enables noninvasive MRI-guided formation of small destruction foci in the relevant targets, providing therapeutic neuromodulating effects in patients with Parkinson's disease, essential tremor, pain syndromes, obsessive-compulsive disorders, and other diseases. So far, thi...

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“…Thus the effects of clot disruption are obtained more mechanically, and cavitation effects are considered to make the biggest contribution during the process. 3,5,[10][11][12] As a result, high acoustic peak negative pressure (as high as 19 MPa 13 ) at relatively low ultrasound frequencies such as 500 kHz or 1 MHz are used so that cavitation can be effectively induced. However, at such low ultrasound frequencies, the focal spot of the ultrasound field can be larger than 10 mm in length, which is larger than the diameters of most veins.…”

Section: Introductionmentioning

confidence: 99%

“…The addition of intravenously injected microbubbles can enhance the effects of ultrasound and reduce the required energy for producing ultrasound-mediated thrombolysis by decreasing cavitation threshold. 3,12,14,15 Also, a few of studies 16 have shown that HIFU can improve thrombolysis while applying thrombolytic agents by reducing the dosage of the drug and reducing the risk of hemorrhagic events, but increasing its efficacy. In addition, microbubbles and thrombolytic drugs can be combined together for targeted drug delivery, drug transport acceleration [17][18][19][20][21] and eventually enhancing thrombolysis.…”

Section: Introductionmentioning

confidence: 99%

Laser enhanced high-intensity focused ultrasound thrombolysis: An in vitro study

Cui¹,

Yang²

2013

The Journal of the Acoustical Society of America

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Laser-enhanced thrombolysis by high intensity focused ultrasound (HIFU) treatment was studied in vitro with bovine blood clots. To achieve laser-enhanced thrombolysis, laser light was employed to illuminate the sample concurrently with HIFU radiation, and ultrasound and laser parameters were optimized to achieve better thrombolysis efficiency. The results indicated that the thrombolysis efficiency increased when pulse length of HIFU wave, HIFU pressure, or laser fluence increases. Also, with the presence of laser, an enhanced effect of thrombolysis was observed.

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Ultrasound Imaging–Guided Noninvasive Ultrasound Thrombolysis

Abstract: External high-intensity focused ultrasound thrombolysis using optimal PW parameters for periods of

Cited by 129 publications

References 28 publications

Ultrasonic drug delivery – a general review

Ultrasonic drug delivery – a general review

The use of transcranial focused ultrasound in CNS diseases

Laser enhanced high-intensity focused ultrasound thrombolysis: An in vitro study

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