Evaluation of high resolution ultrasound as a tool for assessing the 3D volume of blood clots during in vitro thrombolysis

Laurent Auboire,Jean-René Jacquet,Jean-Marc Grégoire,Jean-Michel Escoffre,Frédéric Ossant,Ayache Bouakaz,Damien Fouan

doi:10.1038/s41598-017-06089-z

Abstract

Thrombosis is a major cause of several diseases, i.e. myocardial infarction, cerebral stroke and pulmonary embolism. Thrombolytic therapies are required to induce fast and efficient recanalization of occluded vessels. To evaluate the in vitro efficacy of these thrombolytic strategies, measuring clot dissolution is essential. This study aimed to evaluate and validate high resolution ultrasound as a tool to assess the exact volume of clots in 3D and in real time during in vitro thrombolytic drug testing. This new method was validated by measuring the effects of concentration range of recombinant tissue type plasminogen activator on a blood clot during complete occlusion or 70% stenosis of a vessel. This study shows that high resolution ultrasound imaging allows for a real-time assessment of the 3D volume of a blood clot with negligible inter- and intra-operator variabilities. The conclusions drawn from this study demonstrate the promising potential of high resolution ultrasound imaging for the in vitro assessment of new thrombolytic drugs.

Highlights

Thrombosis is a major cause of several cardiovascular diseases; among them, the deadliest are myocardial infarction and acute cerebral stroke
Human blood clots are composed of variable proportions of fibrin, red and white blood cells in acute stroke[2], the use of clots generated from platelet-rich plasma has been reported[9]
The present work suggests that high frequency ultrasound imaging is a reliable imaging modality to assess the in vitro thrombolytic efficacy of drugs

Summary

Introduction

Thrombosis is a major cause of several cardiovascular diseases; among them, the deadliest are myocardial infarction and acute cerebral stroke. Treatment of ischemic stroke using Rt-PA as a single agent has shown effective recanalization of an artery in only 42% of patients, these rates can reach 85% when used in combination with stent retrieval, leading to a more important percentage of patients who are functionally independent at 90 days[5]. This last method, which consists of removing the blood clot with an intra-arterial (i.a.) catheter, is mainly used when Rt-PA is contra-indicated.

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