Abstract
One of the great advancements in the applications of piezoelectric materials is the application for therapeutic medical ultrasound for sonothrombolysis. Sonothrombolysis is a promising ultrasound based technique to treat blood clots compared to conventional thrombolytic treatments or mechanical thrombectomy. Recent clinical trials using transcranial Doppler ultrasound, microbubble mediated sonothrombolysis, and catheter directed sonothrombolysis have shown promise. However, these conventional sonothrombolysis techniques still pose clinical safety limitations, preventing their application for standard of care. Recent advances in sonothrombolysis techniques including targeted and drug loaded microbubbles, phase change nanodroplets, high intensity focused ultrasound, histotripsy, and improved intravascular transducers, address some of the limitations of conventional sonothrombolysis treatments. Here, we review the strengths and limitations of these latest pre-clincial advancements for sonothrombolysis and their potential to improve clinical blood clot treatments.
Highlights
Blood clots are a leading problem for health complications, with over 300,000 new cases of thrombi occurring in the United States annually [1,2]
The other blood clot of concern are deep vein thrombosis (DVT), which can greatly increase the risk of patients developing a pulmonary embolism and are a common source of post-surgery complications
The purpose of this review is to summarize the latest developments of sonothrombolysis techniques and their mechanisms which are still in the pre-clinical stages
Summary
Blood clots are a leading problem for health complications, with over 300,000 new cases of thrombi occurring in the United States annually [1,2]. Sensors 2020, 20, 1288 catheter based thrombolysis treatments are used to help administer the thrombolytic agents directly to the clot of interest; these drugs are still circulated systemically, increasing the risk for non-intended clot lysis. While these treatments are effective, further work needs to be done to mitigate the serious side effects of these approaches. In addition to improving thrombolytic treatment, several studies and clinical trials have demonstrated that ultrasound contrast agents, namely microbubbles (MBs), can be used to enhance clot lysis with tPA by increasing the amount of targeted cavitation, thereby destroying the blood clots while minimizing clot debris [15,18,20,21,23,26,27,29,30,31,32]
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