Abstract
The potential for non-invasive targeted delivery of therapeutic agents and targeted thrombus dissolution using diagnostic ultrasound (DUS) and intravenous microbubbles or droplets is an emerging technology that will change diagnostic ultrasound systems into therapeutic devices. Targeted ultrasound destruction of microbubbles which carry either DNA or inhibitor RNA sequences have been utilized to both promote microvascular regeneration in ischemic myocardium and skeletal muscle and inhibit vascular growth in murine models of carcinoma. Targeted ultrasound microbubble cavitation has been utilized to improve ischemic limb blood flow via nitric oxide pathways and to induce targeted coronary and microvascular recanalization in large animal models of acute ST segment elevation myocardial infarction (STEMI). Initial clinical trials utilizing DUS and commercially available microbubbles in acute STEMI patients prior to, and after, emergent percutaneous coronary intervention have demonstrated the feasibility and efficacy of this approach in preserving microvascular flow.
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