Transcranial Clot Lysis Using High Intensity Focused Ultrasound

Abstract

Stroke is the third common cause of death worldwide. The majority of strokes are caused by sudden vessel occlusion, due to a blood clot. Vessel recanalization is the primary goal of all acute stroke treatment strategies. Initial data using ultrasound in combination with a therapeutic agent for clot lysis in stroke are promising. However, sound absorption and defocusing of the ultrasound beam occur during transskull insonation, limiting the efficiency of this approach to high extent. Using a transskull High Intensity Focused Ultrasound (HIFU) head system we were able to lyse blood clots within seconds and in absence of further lytic agents. We could show that any correction for the distortion might be negligible to focus the ultrasound beam after transskull insonation. The use of transskull HIFU for immediate clot lysis in the human brain without the need of further drugs and disregarding individual skull bone characteristics could become a successful strategy in early stroke treatment. Using magnetic resonance tomography for neuronavigation MRI Guided High Intensity Focused Ultrasound has the potential to open new avenues for therapeutic applications in the brain including Stroke, Intracranial Hemorrhages, Braintumors, Neurodegenerative Diseases, Thalamic Pain, BBB opening, and local drug delivery. First results in transcranial clot lysis will be presented in this paper.