Abstract
BackgroundThe primary goal of this study was to investigate the relationship between increasing output power levels and clot fragmentation during high-intensity focused ultrasound (HIFU)-induced thrombolysis.MethodsA HIFU headsystem, designed for brain applications in humans, was used for this project. A human calvarium was mounted inside the water-filled hemispheric transducer. Artificial thrombi were placed inside the skull and located at the natural focus point of the transducer. Clots were exposed to a range of acoustic output power levels from 0 to 400 W. The other HIFU operating parameters remained constant. To assess clot fragmentation, three filters of different mesh pore sizes were used. To assess sonothrombolysis efficacy, the clot weight loss was measured.ResultsNo evidence of increasing clot fragmentation was found with increasing acoustic intensities in the majority of the study groups of less than 400 W. Increasing clot lysis could be observed with increasing acoustic output powers.ConclusionTranscranial sonothrombolysis could be achieved in vitro within seconds in the absence of tPA and without producing relevant clot fragmentation, using acoustic output powers of <400 W.
Highlights
The primary goal of this study was to investigate the relationship between increasing output power levels and clot fragmentation during high-intensity focused ultrasound (HIFU)-induced thrombolysis
The goal of this study was to investigate the impact of increasing acoustic output powers on potential clot fragmentation, using a novel transcranial high-intensity focused ultrasound (HIFU) headsystem
For the 400 W as well as for the 150-W acoustic output power group, a statistical significant clot fragmentation could be observed for the 180-μm filter size
Summary
The primary goal of this study was to investigate the relationship between increasing output power levels and clot fragmentation during high-intensity focused ultrasound (HIFU)-induced thrombolysis. The majority of strokes are ischemic, caused by intracranial thrombo-embolic arterial occlusion. Vessel recanalization is the primary goal of all acute stroke treatment approaches. Achieving vessel recanalization without causing further damage is a key objective in effective treatment. Innovative recanalization strategies or options to improve tPA efficacy are of high interest. Mechanical (i.e., mechanical embolism removal cerebral ischemia, MERCI) and chemical (i.e., tPA) methods to achieve successful thrombolysis have been evaluated with regard to efficacy and safety. With mechanical removal of a thrombotic occlusion, an undesirable side effect has
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