Diagnostic ultrasound combined with targeted microbubbles improves recovery following acute coronary thrombosis.

Abstract

Forty‐five pigs with acute coronary artery occlusions—low MI pulse sequence (CPS) to guide high MI (1.9 MI) pulses during infusion of platelet‐targeted MBs or non‐targeted MBs. Third group received no ultrasound/MB. All groups received pro‐urokinase, heparin, and aspirin. Angiographic recanalization rates, resolution of ST elevation, and wall thickening were analyzed. Pigs receiving MB had more rapid replenishment of risk area (RA) (80% versus 40% for MB; p=0.03) and higher epicardial recanalization rates (53% versus 7% for pro‐urokinase alone; p=0.01). Replenishment of contrast within RA with MB showed higher recanalization rates and higher rates of ST resolution (82% versus 21% for pro‐urokinase alone; p=0.006). ST resolution occurred in six pigs (40%) with MB who did not have epicardial recanalization; five had recovery of wall thickening. Conclusions: IV MB with brief high MI DUS guided by CPS improves both epicardial recanalization rates and microvascular recovery.