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Huang A, Jia Z, Wu H, Feng K, Zhang C, Wan M, Zong Y. Exploring the Postactivation Behavioral Patterns of Intratumorally Injected Theranostic Nanodroplets: An Ultrasound-Only Extravascular Monitoring Technique. IEEE TRANSACTIONS ON ULTRASONICS, FERROELECTRICS, AND FREQUENCY CONTROL 2024; 71:1186-1198. [PMID: 39196736 DOI: 10.1109/tuffc.2024.3450885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/30/2024]
Abstract
Phase-change nanodroplets (PCNDs) are customizable and controllable theranostic agents of particular interest in extravascular therapies such as drug delivery and histotripsy. High-bulk-boiling-point (HBP) PCNDs are preferred for their enhanced thermal stability under physiological temperature to achieve on-demand therapeutic effects on target sites-mainly in tumor tissue. However, the behavioral patterns of high-concentration, heterogeneously distributed HBP PCNDs in vivo have rarely been explored-the foci of PCND-related therapies mostly fall on the final therapeutic effect rather than the detailed behaviors of PCNDs, which may hamper the development and improvement of in vivo treatments with PCNDs. To fill the gap, we demonstrate an ultrasound-only extravascular monitoring technique to analyze the underlying behavioral patterns of intratumorally injected HBP PCNDs. In our hypothesis, recondensation and coalescence are the two predominant patterns influencing the trend of the postactivation signal of PCNDs. A "blink map" method was, thus, proposed to separate the two parts of the signal by recognizing the unique signal pattern of stochastic recondensation, and four derivative metrics were calculated for further analysis. The results revealed the postactivation patterns of PCNDs at different activation-pulse durations and activation stages throughout the activation-imaging period, and several general trends were observed and explained by existing theories, suggesting the feasibility of our extravascular monitoring technique. Overall, this work enriches the knowledge of the characteristics of HBP PCNDs as extravascular theranostic agents, and the monitoring results have the potential to provide timely feedback on PCND-related treatments underway, which may help adjust the treatment strategy and improve the therapeutic efficacy.
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Zheng X, Pan Y, Wang Z, Zhang S. Effect of Ultrasound on Thrombus debris during Sonothrombolysis in a Microfluidic device. J Thromb Thrombolysis 2024; 57:1056-1066. [PMID: 38824486 DOI: 10.1007/s11239-024-03005-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/13/2024] [Indexed: 06/03/2024]
Abstract
Microbubble-mediated sonothrombolysis has been proven to be a non-invasive and efficient method for thrombolysis. Nevertheless, there is a potential risk that the thrombus debris generated during the dissolution of the original thrombus are too large and can lead to hazardous emboli. Using a sonothrombolysis microfluidic platform, we investigated the effects of ultrasound power, thrombolytic agent and microbubble concentration on the size of thrombus debris with the example of microbubble-mediated sonothrombolysis of arterial thrombus. Additionally, we studied the effects of ultrasound power on the size and shape of thrombus debris produced by acute and chronic arterial sonothrombolysis. In acute arterial sonothrombolysis, ultrasound power has significant effect on the size of thrombus debris and steadily increases with the increase of ultrasound power. Conversely, in chronic arterial sonothrombolysis, the size of thrombus debris is minimally affected by ultrasound power. Using the sonothrombolysis microfluidic platform, the relationship between ultrasound power and the safety of sonothrombolysis has been illustrated, and the sonothrombolysis microfluidic platform is demonstrated to be a promising tool for further studies on the process of sonothrombolysis.
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Affiliation(s)
- Xiaobing Zheng
- State Key Laboratory of Tribology, Department of Mechanical Engineering, Tsinghua University, Beijing, 100084, China.
| | - Yunfan Pan
- State Key Laboratory of Tribology, Department of Mechanical Engineering, Tsinghua University, Beijing, 100084, China
| | - Zhaojian Wang
- Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, 100730, China
| | - Shuguang Zhang
- State Key Laboratory of Tribology, Department of Mechanical Engineering, Tsinghua University, Beijing, 100084, China.
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Yang S, Zemzemi C, Escudero DS, Vela DC, Haworth KJ, Holland CK. Histotripsy and Catheter-Directed Lytic: Efficacy in Highly Retracted Porcine Clots In Vitro. ULTRASOUND IN MEDICINE & BIOLOGY 2024; 50:1167-1177. [PMID: 38777639 DOI: 10.1016/j.ultrasmedbio.2024.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 04/02/2024] [Accepted: 04/05/2024] [Indexed: 05/25/2024]
Abstract
OBJECTIVE Standard treatment for deep vein thrombosis (DVT) involves catheter-directed anticoagulants or thrombolytics, but the chronic thrombi present in many DVT cases are often resistant to this therapy. Histotripsy has been found to be a promising adjuvant treatment, using the mechanical action of cavitating bubble clouds to enhance thrombolytic activity. The objective of this study was to determine if histotripsy enhanced recombinant tissue plasminogen activator (rt-PA) thrombolysis in highly retracted porcine clots in vitro in a flow model of occlusive DVT. METHODS Highly retracted porcine whole blood clots were treated for 1 h with either catheter-directed saline (negative control), rt-PA (lytic control), histotripsy, DEFINITY and histotripsy or the combination of rt-PA and histotripsy with or without DEFINITY. Five-cycle, 1.5 MHz histotripsy pulses with a peak negative pressure of 33.2 MPa and pulse repetition frequency of 40 Hz were applied along the clot. B-Mode and passive cavitation images were acquired during histotripsy insonation to monitor bubble activity. RESULTS Clots subjected to histotripsy with and without rt-PA exhibited greater thrombolytic efficacy than controls (7.0% flow recovery or lower), and histotripsy with rt-PA was more efficacious than histotripsy with saline (86.1 ± 10.2% compared with 61.7 ± 19.8% flow recovery). The addition of DEFINITY to histotripsy with or without rt-PA did not enhance either thrombolytic efficacy or cavitation dose. Cavitation dose generally did not correlate with thrombolytic efficacy. CONCLUSION Enhancement of thrombolytic efficacy was achieved using histotripsy, with and without catheter-directed rt-PA, in the presence of physiologic flow. This suggests these treatments may be effective as therapy for DVT.
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Affiliation(s)
- Shumeng Yang
- Department of Biomedical Engineering, University of Cincinnati, Cincinnati, OH, USA.
| | - Chadi Zemzemi
- Department of Internal Medicine, University of Cincinnati, Cincinnati, OH, USA
| | | | - Deborah C Vela
- Cardiovascular Pathology, Texas Heart Institute, Houston, TX, USA
| | - Kevin J Haworth
- Department of Internal Medicine, University of Cincinnati, Cincinnati, OH, USA; Department of Biomedical Engineering, University of Cincinnati, Cincinnati, OH, USA
| | - Christy K Holland
- Department of Internal Medicine, University of Cincinnati, Cincinnati, OH, USA; Department of Biomedical Engineering, University of Cincinnati, Cincinnati, OH, USA
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Gong L, Wright AR, Hynynen K, Goertz DE. Inducing cavitation within hollow cylindrical radially polarized transducers for intravascular applications. ULTRASONICS 2024; 138:107223. [PMID: 38553135 DOI: 10.1016/j.ultras.2023.107223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 10/31/2023] [Accepted: 12/12/2023] [Indexed: 04/02/2024]
Abstract
Thrombotic occlusions of large blood vessels are increasingly treated with catheter based mechanical approaches, one of the most prominent being to employ aspiration to extract clots through a hollow catheter lumen. A central technical challenge for aspiration catheters is to achieve sufficient suction force to overcome the resistance of clot material entering into the distal tip. In this study, we examine the feasibility of inducing cavitation within hollow cylindrical transducers with a view to ultimately using them to degrade the mechanical integrity of thrombus within the tip of an aspiration catheter. Hollow cylindrical radially polarized PZT transducers with 3.3/2.5 mm outer/inner diameters were assessed. Finite element simulations and hydrophone experiments were used to investigate the pressure field distribution as a function of element length and resonant mode (thickness, length). Operating in thickness mode (∼5 MHz) was found to be associated with the highest internal pressures, estimated to exceed 23 MPa. Cavitation was demonstrated to be achievable within the transducer under degassed water (10 %) conditions using hydrophone detection and high-frequency ultrasound imaging (40 MHz). Cavitation clouds occupied a substantial portion of the transducer lumen, in a manner that was dependent on the pulsing scheme employed (10 and 100 μs pulse lengths; 1.1, 11, and 110 ms pulse intervals). Collectively the results support the feasibility of achieving cavitation within a transducer compatible with mounting in the tip of an aspiration format catheter.
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Affiliation(s)
- Li Gong
- Department of Medical Biophysics, University of Toronto, Canada; Physical Sciences Platform, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Canada.
| | - Alex R Wright
- Physical Sciences Platform, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Canada
| | - Kullervo Hynynen
- Department of Medical Biophysics, University of Toronto, Canada; Physical Sciences Platform, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Canada; Institute of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, Canada
| | - David E Goertz
- Department of Medical Biophysics, University of Toronto, Canada; Physical Sciences Platform, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Canada
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Woodward A, Mattrey RF, de Gracia Lux C. Direct Emulsification of Stable Superheated Perfluorobutane Nanodroplets by Sonication: Addressing the Limitations of the Microbubble Condensation Technique. ULTRASOUND IN MEDICINE & BIOLOGY 2024; 50:445-452. [PMID: 38171955 DOI: 10.1016/j.ultrasmedbio.2023.12.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 10/18/2023] [Accepted: 12/05/2023] [Indexed: 01/05/2024]
Abstract
OBJECTIVE We have previously determined that direct formulation of a phospholipid-based perfluorobutane (PFB) emulsion using high-pressure homogenization produces monodispersed PFB nanodroplets (NDs) with relatively few non-PFB-filled NDs. In this article, we describe a simpler strategy to reproducibly formulate highly concentrated superheated PFB NDs using a probe sonicator, a more widely available tool. METHODS Similar to the homogenization technique, sonicating at low power a solution of phospholipids with condensed PFB at -10°C consistently yields NDs with an encapsulation efficiency close to 100% and very few non-PFB-filled particles. RESULTS The PFB emulsion is stable with absence of spontaneous vaporization at 37°C and for more than 14 d when frozen or refrigerated and for 3 d at 25°C. Acoustic droplet vaporization (ADV) occurred at a mechanical index >0.5 and continued to increase thereafter. The ADV threshold was similar for freshly made or frozen emulsion after thawing. In contrast to the microbubble (MB) condensation method, in which the ratio of non-PFB-filled to PFB-filled is 2000:1, particularly if MBs are not washed after formulation, nearly 94% of particles produced by direct sonication are PFB filled. CONCLUSION PFB NDs can be manufactured with high yield, stability and reproducibility using a probe sonicator that is available in many laboratories. Their ease of manufacture could spark discoveries into highly impactful ND-based diagnostic and therapeutic applications.
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Affiliation(s)
- Adam Woodward
- Department of Radiology, Translational Research in Ultrasound Theranostics (TRUST) Program, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Robert F Mattrey
- Department of Radiology, Translational Research in Ultrasound Theranostics (TRUST) Program, University of Texas Southwestern Medical Center, Dallas, TX, USA; Advanced Imaging Research Center, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Caroline de Gracia Lux
- Department of Radiology, Translational Research in Ultrasound Theranostics (TRUST) Program, University of Texas Southwestern Medical Center, Dallas, TX, USA; Biomedical Engineering Graduate Program, University of Texas Southwestern Medical Center, Dallas, TX, USA.
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Liao M, Du J, Chen L, Huang J, Yang R, Bao W, Zeng K, Wang W, Aphan BC, Wu Z, Ma L, Lu Q. Sono-activated materials for enhancing focused ultrasound ablation: Design and application in biomedicine. Acta Biomater 2024; 173:36-50. [PMID: 37939816 DOI: 10.1016/j.actbio.2023.11.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 10/30/2023] [Accepted: 11/02/2023] [Indexed: 11/10/2023]
Abstract
The ablation effect of focused ultrasound (FUS) has played an increasingly important role in the biomedical field over the past decades, and its non-invasive features have great advantages, especially for clinical diseases where surgical treatment is not available or appropriate. Recently, rapid advances in the adjustable morphology, enzyme-mimetic activity, and biostability of sono-activated materials have significantly promoted the medical application of FUS ablation. However, a systematic review of sono-activated materials based on FUS ablation is not yet available. This progress review focuses on the recent design, fundamental principles, and applications of sono-activated materials in the FUS ablation biomedical field. First, the different ablation mechanisms and the key factors affecting ablation are carefully determined. Then, the design of sono-activated materials with high FUS ablation efficiencies is comprehensively discussed. Subsequently, the representative biological applications are summarized in detail. Finally, the primary challenges and future perspectives are also outlined. We believe this timely review will provide key information and insights for further exploration of focused ultrasound ablation and new inspiration for designing future sono-activated materials. STATEMENT OF SIGNIFICANCE: The ablation effect of focused ultrasound (FUS) has played an increasingly important role in the biomedical field over the past decades. However, there are also some challenges of FUS ablation, such as skin burns, tumour recurrence after thermal ablation, and difficulty in controlling cavitation ablation. The rapid advance in adjustable morphology, enzyme-mimetic activity, and biostability of sono-activated materials has significantly promoted the medical application of FUS ablation. However, the systematic review of sono-activated materials based on FUS ablation is not yet available. This progress review focuses on the recent design, fundamental principles, and applications in the FUS ablation biomedical field of sono-activated materials. We believe this timely review will provide key information and insights for further exploration of FUS ablation.
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Affiliation(s)
- Min Liao
- Department of Ultrasound, Frontiers Science Center for Disease-Related Molecular Network, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Jinpeng Du
- Department of Hepatobiliary and Pancreatic Surgery, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, 450052, China
| | - Lin Chen
- School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, 610054, China
| | - Jiayan Huang
- Department of Ultrasound, Frontiers Science Center for Disease-Related Molecular Network, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Rui Yang
- Department of Ultrasound, Frontiers Science Center for Disease-Related Molecular Network, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Wuyongga Bao
- Department of Ultrasound, Frontiers Science Center for Disease-Related Molecular Network, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Keyu Zeng
- Department of Ultrasound, Frontiers Science Center for Disease-Related Molecular Network, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Wenhui Wang
- Department of Ultrasound, Frontiers Science Center for Disease-Related Molecular Network, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Benjamín Castañeda Aphan
- Department of Engineering, Medical Imaging Laboratory, Pontificia Universidad Católica del Perú, Lima, Peru
| | - Zhe Wu
- School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, 610054, China.
| | - Lang Ma
- Department of Ultrasound, Frontiers Science Center for Disease-Related Molecular Network, West China Hospital, Sichuan University, Chengdu, 610041, China.
| | - Qiang Lu
- Department of Ultrasound, Frontiers Science Center for Disease-Related Molecular Network, West China Hospital, Sichuan University, Chengdu, 610041, China.
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Kim H, Zhang B, Wu H, Yao J, Shi C, Jiang X. Vortex-ultrasound for microbubble-mediated thrombolysis of retracted clots. APPLIED PHYSICS LETTERS 2023; 123:073701. [PMID: 37600080 PMCID: PMC10435273 DOI: 10.1063/5.0155223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 08/02/2023] [Indexed: 08/22/2023]
Abstract
Endovascular sonothrombolysis has gained significant attention due to its benefits, including direct targeting of the thrombus with sonication and reduced side effects. However, the small aperture of endovascular transducers restricts the improvement of their potential clinical efficiency due to inefficient acoustic radiation. Hence, in an earlier study, we used vortex ultrasound with an endovascular ultrasound transducer to induce shear stress and enhance the clot lysis. In this study, the vortex acoustic transduction mechanism was investigated using numerical simulations and hydrophone tests. Following this characterization, we demonstrated the performance of the vortex ultrasound transducer in thrombolysis of retracted clots in in vitro tests. The test results indicated that the maximum lysis rates were 79.0% and 32.2% with the vortex ultrasound for unretracted and retracted clots, respectively. The vortex ultrasound enhanced the efficiency of the thrombolysis by approximately 49%, both for retracted and unretracted clots, compared with the typical non-vortex ultrasound technique. Therefore, the use of endovascular vortex ultrasound holds promise as a potential clinical option for the thrombolysis of retracted clots.
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Affiliation(s)
| | - Bohua Zhang
- Department of Mechanical and Aerospace Engineering, North Carolina State University, Raleigh, North Carolina 27695, USA
| | - Huaiyu Wu
- Department of Mechanical and Aerospace Engineering, North Carolina State University, Raleigh, North Carolina 27695, USA
| | - Junjie Yao
- Department of Biomedical Engineering, Duke University, Durham, North Carolina 27708, USA
| | - Chengzhi Shi
- Authors to whom correspondence should be addressed: and
| | - Xiaoning Jiang
- Department of Mechanical and Aerospace Engineering, North Carolina State University, Raleigh, North Carolina 27695, USA
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Wu H, Tang Y, Zhang B, Klippel P, Jing Y, Yao J, Jiang X. Miniaturized Stacked Transducer for Intravascular Sonothrombolysis With Internal-Illumination Photoacoustic Imaging Guidance and Clot Characterization. IEEE Trans Biomed Eng 2023; 70:2279-2288. [PMID: 37022249 PMCID: PMC10399617 DOI: 10.1109/tbme.2023.3240725] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Thromboembolism in blood vessels can lead to stroke or heart attack and even sudden death unless brought under control. Sonothrombolysis enhanced by ultrasound contrast agents has shown promising outcome on effective treatment of thromboembolism. Intravascular sonothrombolysis was also reported recently with a potential for effective and safe treatment of deep thrombosis. Despite the promising treatment results, the treatment efficiency for clinical application may not be optimized due to the lack of imaging guidance and clot characterization during the thrombolysis procedure. In this paper, a miniaturized transducer was designed to have an 8-layer PZT-5A stacked with an aperture size of 1.4 × 1.4 mm2 and assembled in a customized two-lumen 10-Fr catheter for intravascular sonothrombolysis. The treatment process was monitored with internal-illumination photoacoustic tomography (II-PAT), a hybrid imaging modality that combines the rich contrast of optical absorption and the deep penetration of ultrasound detection. With intravascular light delivery using a thin optical fiber integrated with the intravascular catheter, II-PAT overcomes the penetration depth limited by strong optical attenuation of tissue. In-vitro PAT-guided sonothrombolysis experiments were carried out with synthetic blood clots embedded in tissue phantom. Clot position, shape, stiffness, and oxygenation level can be estimated by II-PAT at clinically relevant depth of ten centimeters. Our findings have demonstrated the feasibility of the proposed PAT-guided intravascular sonothrombolysis with real-time feedback during the treatment process.
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Drakos T, Evripidou G, Damianou C. An in vitro Model for Experimental Evaluation of Sonothrombolysis under Tissue-mimicking Material Conditions. J Med Ultrasound 2023; 31:211-217. [PMID: 38025011 PMCID: PMC10668898 DOI: 10.4103/jmu.jmu_52_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2022] [Revised: 07/12/2022] [Accepted: 08/10/2022] [Indexed: 12/01/2023] Open
Abstract
Background The mechanical properties of therapeutic ultrasound (US) have attracted scientific interest for thrombolysis enhancement in combination with thrombolytic agents and microbubbles (MBs). The aim of the study was to develop an in vitro model to observe how the effects of sonothrombolysis change in the case where a tissue-mimicking material (TMM) is placed in the path of the US beam before the clot. Methods Fully retracted blood clots were prepared and pulse sonicated for 1 h under various conditions. The system was in a state of real circulating flow with a branch of an open bypass and an occluded tube containing a blood clot, thus mimicking the case of ischemic stroke. The effectiveness of thrombolysis was quantified in milligrams of clots removed. An agar-based TMM was developed around the occluded tube. Results The clot breakdown in a TMM was found to be more pronounced than in water, presumably due to the retention of the acoustic field. A higher level of acoustic power was required to initiate clot lysis (>76 W acoustic power) using only focused US (FUS). The greatest thrombolysis enhancement was observed with the largest chosen pulse duration (PD) and the use of MBs (150 mg clot mass lysis). The synergistic effect of FUS in combination with MBs on the enzymatic fibrinolysis enhanced thrombolysis efficacy by 260% compared to thrombolysis induced using only FUS. A reduction in the degree of clot lysis was detected due to the attenuation factor of the intervening material (30 mg at 1 and 4 ms PD). Conclusion In vitro thrombolytic models including a TMM can provide a more realistic evaluation of new thrombolytic protocols. However, higher acoustic power should be considered to compensate for the attenuation factor. The rate of clot lysis is slow and the clinical use of this method will be challenging.
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Affiliation(s)
| | - Georgios Evripidou
- Department of Electrical Engineering, Computer Engineering, and Informatics, Cyprus University of Technology, Limassol, Cyprus
| | - Christakis Damianou
- Department of Electrical Engineering, Computer Engineering, and Informatics, Cyprus University of Technology, Limassol, Cyprus
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Zhang B, Jiang X. Magnetic Nanoparticles Mediated Thrombolysis-A Review. IEEE OPEN JOURNAL OF NANOTECHNOLOGY 2023; 4:109-132. [PMID: 38111792 PMCID: PMC10727495 DOI: 10.1109/ojnano.2023.3273921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/20/2023]
Abstract
Nanoparticles containing thrombolytic medicines have been developed for thrombolysis applications in response to the increasing demand for effective, targeted treatment of thrombosis disease. In recent years, there has been a great deal of interest in nanoparticles that can be navigated and driven by a magnetic field. However, there are few review publications concerning the application of magnetic nanoparticles in thrombolysis. In this study, we examine the current state of magnetic nanoparticles in the application of in vitro and in vivo thrombolysis under a static or dynamic magnetic field, as well as the combination of magnetic nanoparticles with an acoustic field for dual-mode thrombolysis. We also discuss four primary processes of magnetic nanoparticles mediated thrombolysis, including magnetic nanoparticle targeting, magnetic nanoparticle trapping, magnetic drug release, and magnetic rupture of blood clot fibrin networks. This review will offer unique insights for the future study and clinical development of magnetic nanoparticles mediated thrombolysis approaches.
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Affiliation(s)
- Bohua Zhang
- Department of Mechanical and Aerospace Engineering, North Carolina State University, Raleigh, NC 27695 USA
| | - Xiaoning Jiang
- Department of Mechanical and Aerospace Engineering, North Carolina State University, Raleigh, NC 27695 USA
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Bautista KJB, Kim J, Xu Z, Jiang X, Dayton PA. Current Status of Sub-micron Cavitation-Enhancing Agents for Sonothrombolysis. ULTRASOUND IN MEDICINE & BIOLOGY 2023; 49:1049-1057. [PMID: 36868959 DOI: 10.1016/j.ultrasmedbio.2023.01.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 01/11/2023] [Accepted: 01/23/2023] [Indexed: 05/11/2023]
Abstract
Thrombosis in cardiovascular disease is an urgent global issue, but treatment progress is limited by the risks of current antithrombotic approaches. The cavitation effect in ultrasound-mediated thrombolysis offers a promising mechanical alternative for clot lysis. Further addition of microbubble contrast agents introduces artificial cavitation nuclei that can enhance the mechanical disruption induced by ultrasound. Recent studies have proposed sub-micron particles as novel sonothrombolysis agents with increased spatial specificity, safety and stability for thrombus disruption. In this article, the applications of different sub-micron particles for sonothrombolysis are discussed. Also reviewed are in vitro and in vivo studies that apply these particles as cavitation agents and as adjuvants to thrombolytic drugs. Finally, perspectives on future developments in sub-micron agents for cavitation-enhanced sonothrombolysis are shared.
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Affiliation(s)
- Kathlyne Jayne B Bautista
- Joint Department of Biomedical Engineering, University of North Carolina at Chapel Hill and North Carolina State University, Chapel Hill, NC, USA
| | - Jinwook Kim
- Joint Department of Biomedical Engineering, University of North Carolina at Chapel Hill and North Carolina State University, Chapel Hill, NC, USA
| | - Zhen Xu
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, USA
| | - Xiaoning Jiang
- Department of Mechanical and Aerospace Engineering, North Carolina State University, Raleigh, NC, USA
| | - Paul A Dayton
- Joint Department of Biomedical Engineering, University of North Carolina at Chapel Hill and North Carolina State University, Chapel Hill, NC, USA.
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Tan ZQ, Ooi EH, Chiew YS, Foo JJ, Ng EYK, Ooi ET. A computational framework for the multiphysics simulation of microbubble-mediated sonothrombolysis using a forward-viewing intravascular transducer. ULTRASONICS 2023; 131:106961. [PMID: 36812819 DOI: 10.1016/j.ultras.2023.106961] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 01/08/2023] [Accepted: 02/13/2023] [Indexed: 06/18/2023]
Abstract
Sonothrombolysis is a technique that utilises ultrasound waves to excite microbubbles surrounding a clot. Clot lysis is achieved through mechanical damage induced by acoustic cavitation and through local clot displacement induced by acoustic radiation force (ARF). Despite the potential of microbubble-mediated sonothrombolysis, the selection of the optimal ultrasound and microbubble parameters remains a challenge. Existing experimental studies are not able to provide a complete picture of how ultrasound and microbubble characteristics influence the outcome of sonothrombolysis. Likewise, computational studies have not been applied in detail in the context of sonothrombolysis. Hence, the effect of interaction between the bubble dynamics and acoustic propagation on the acoustic streaming and clot deformation remains unclear. In the present study, we report for the first time the computational framework that couples the bubble dynamic phenomena with the acoustic propagation in a bubbly medium to simulate microbubble-mediated sonothrombolysis using a forward-viewing transducer. The computational framework was used to investigate the effects of ultrasound properties (pressure and frequency) and microbubble characteristics (radius and concentration) on the outcome of sonothrombolysis. Four major findings were obtained from the simulation results: (i) ultrasound pressure plays the most dominant role over all the other parameters in affecting the bubble dynamics, acoustic attenuation, ARF, acoustic streaming, and clot displacement, (ii) smaller microbubbles could contribute to a more violent oscillation and improve the ARF simultaneously when they are stimulated at higher ultrasound pressure, (iii) higher microbubbles concentration increases the ARF, and (iv) the effect of ultrasound frequency on acoustic attenuation is dependent on the ultrasound pressure. These results may provide fundamental insight that is crucial in bringing sonothrombolysis closer to clinical implementation.
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Affiliation(s)
- Zhi Q Tan
- Mechanical Engineering Discipline, School of Engineering, Monash University Malaysia, Jalan Lagoon Selatan, 47500 Bandar Sunway, Selangor, Malaysia
| | - Ean H Ooi
- Mechanical Engineering Discipline, School of Engineering, Monash University Malaysia, Jalan Lagoon Selatan, 47500 Bandar Sunway, Selangor, Malaysia; Advanced Engineering Platform, Monash University Malaysia, Jalan Lagoon Selatan, 47500 Bandar Sunway, Selangor, Malaysia.
| | - Yeong S Chiew
- Mechanical Engineering Discipline, School of Engineering, Monash University Malaysia, Jalan Lagoon Selatan, 47500 Bandar Sunway, Selangor, Malaysia
| | - Ji J Foo
- Mechanical Engineering Discipline, School of Engineering, Monash University Malaysia, Jalan Lagoon Selatan, 47500 Bandar Sunway, Selangor, Malaysia
| | - Eddie Y K Ng
- School of Mechanical and Aerospace Engineering, College of Engineering, Nanyang Technological University, 50 Nanyang Avenue 639798, Singapore
| | - Ean T Ooi
- School of Engineering and Information Technology, Faculty of Science and Technology, Federation University, VIC 3350, Australia
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Zhang B, Wu H, Kim H, Welch PJ, Cornett A, Stocker G, Nogueira RG, Kim J, Owens G, Dayton PA, Xu Z, Shi C, Jiang X. A Model of High-Speed Endovascular Sonothrombolysis with Vortex Ultrasound-Induced Shear Stress to Treat Cerebral Venous Sinus Thrombosis. RESEARCH (WASHINGTON, D.C.) 2023; 6:0048. [PMID: 37040522 PMCID: PMC10078321 DOI: 10.34133/research.0048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 12/22/2022] [Indexed: 01/13/2023]
Abstract
This research aims to demonstrate a novel vortex ultrasound enabled endovascular thrombolysis method designed for treating cerebral venous sinus thrombosis (CVST). This is a topic of substantial importance since current treatment modalities for CVST still fail in as many as 20% to 40% of the cases, and the incidence of CVST has increased since the outbreak of the coronavirus disease 2019 pandemic. Compared with conventional anticoagulant or thrombolytic drugs, sonothrombolysis has the potential to remarkably shorten the required treatment time owing to the direct clot targeting with acoustic waves. However, previously reported strategies for sonothrombolysis have not demonstrated clinically meaningful outcomes (e.g., recanalization within 30 min) in treating large, completely occluded veins or arteries. Here, we demonstrated a new vortex ultrasound technique for endovascular sonothrombolysis utilizing wave-matter interaction-induced shear stress to enhance the lytic rate substantially. Our in vitro experiment showed that the lytic rate was increased by at least 64.3% compared with the nonvortex endovascular ultrasound treatment. A 3.1-g, 7.5-cm-long, completely occluded in vitro 3-dimensional model of acute CVST was fully recanalized within 8 min with a record-high lytic rate of 237.5 mg/min for acute bovine clot in vitro. Furthermore, we confirmed that the vortex ultrasound causes no vessel wall damage over ex vivo canine veins. This vortex ultrasound thrombolysis technique potentially presents a new life-saving tool for severe CVST cases that cannot be efficaciously treated using existing therapies.
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Affiliation(s)
- Bohua Zhang
- Department of Mechanical & Aerospace Engineering, North Carolina State University, Raleigh, NC, USA
| | - Huaiyu Wu
- Department of Mechanical & Aerospace Engineering, North Carolina State University, Raleigh, NC, USA
| | - Howuk Kim
- Department of Mechanical & Aerospace Engineering, North Carolina State University, Raleigh, NC, USA
- Department of Mechanical Engineering, Inha University, Incheon, Republic of Korea
| | - Phoebe J. Welch
- George W. Woodruff School of Mechanical Engineering, Georgia Institute of Technology, Atlanta, GA, USA
| | - Ashley Cornett
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, USA
| | - Greyson Stocker
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, USA
| | - Raul G. Nogueira
- Department of Neurology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Jinwook Kim
- Department of Biomedical Engineering, University of North Carolina, Chapel Hill, NC, USA
| | - Gabe Owens
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, USA
| | - Paul A. Dayton
- Department of Biomedical Engineering, University of North Carolina, Chapel Hill, NC, USA
| | - Zhen Xu
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, USA
| | - Chengzhi Shi
- George W. Woodruff School of Mechanical Engineering, Georgia Institute of Technology, Atlanta, GA, USA
- Parker H. Petit Institute for Bioengineering and Bioscience, Georgia Institute of Technology, Atlanta, GA, USA
| | - Xiaoning Jiang
- Department of Mechanical & Aerospace Engineering, North Carolina State University, Raleigh, NC, USA
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14
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Rayes A, Zhang J, Lu G, Qian X, Schroff ST, Ryu R, Jiang X, Zhou Q. Estimating Thrombus Elasticity by Shear Wave Elastography to Evaluate Ultrasound Thrombolysis for Thrombus With Different Stiffness. IEEE Trans Biomed Eng 2023; 70:135-143. [PMID: 35759590 PMCID: PMC10370280 DOI: 10.1109/tbme.2022.3186586] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
OBJECTIVE There is uncertainty about deep vein thrombosis standard treatment as thrombus stiffness alters each case. Here, we investigated thrombus' stiffness of different compositions and ages using shear wave elastography (SWE). We then studied the effectiveness of ultrasound-thrombolysis on different thrombus compositions. METHODS Shear waves generated through mechanical shaker and traveled along thrombus of different hematocrit (HCT) levels, whereas 18-MHz ultrasound array used to detect wave propagation. Thrombus' stiffness was identified by the shear wave speed (SWS). In thrombolysis, a 3.2 MHz focused transducer was applied to different thrombus compositions using different powers. The thrombolysis rate was defined as the percentage of weight loss. RESULTS The estimated average SWS of 20%, 40%, and 60% HCT thrombus were 0.75 m/s, 0.44 m/s, and 0.32 m/s, respectively. For Thrombolysis, the percentage weight loss at 8 MPa Negative pressure for the same HCT groups were 23.1%, 35.29%, and 39.66% respectively. CONCLUSION SWS is inversely related to HCT level and positively related to thrombus age. High HCT thrombus had higher weight loss compared to low HCT. However, the difference between 20% and 40% HCT was more significant than between 40% and 60% HCT in both studies. Our results suggest that thrombus with higher SWS require more power to achieve the same thrombolysis rate as thrombus with lower SWS. SIGNIFICANCE Characterizing thrombus elastic property undergoing thrombolysis enables evaluation of ultrasound efficacy for fractionating thrombus and reveals the appropriate ultrasound parameters selection to achieve a certain thrombolysis rate in the case of a specific thrombus stiffness.
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Affiliation(s)
- Adnan Rayes
- Department of Biomedical Engineering, University of Southern California, Los Angeles, CA 90089, USA
- Department of Ophthalmology, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
| | - Junhang Zhang
- Department of Biomedical Engineering, University of Southern California, Los Angeles, CA 90089, USA
- Department of Ophthalmology, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
| | - Gengxi Lu
- Department of Biomedical Engineering, University of Southern California, Los Angeles, CA 90089, USA
- Department of Ophthalmology, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
| | - Xuejun Qian
- Department of Biomedical Engineering, University of Southern California, Los Angeles, CA 90089, USA
- Department of Ophthalmology, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
| | - Stuart T. Schroff
- Department of Radiology, Keck School of Medicine, University of Southern California, Los Angeles, California 90033, USA
| | - Robert Ryu
- Department of Radiology, Keck School of Medicine, University of Southern California, Los Angeles, California 90033, USA
| | - Xiaoning Jiang
- department of Mechanical and Aerospace Engineering, North Carolina State University, Raleigh, NC 27695, USA
| | - Qifa Zhou
- Department of Biomedical Engineering, University of Southern California, Los Angeles, CA 90089, USA
- Department of Ophthalmology, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
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15
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Pan Y, Li Y, Li Y, Zheng X, Zou C, Li J, Chen H. Nanodroplet-Coated Microbubbles Used in Sonothrombolysis with Two-Step Cavitation Strategy. Adv Healthc Mater 2023; 12:e2202281. [PMID: 36433664 DOI: 10.1002/adhm.202202281] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 10/23/2022] [Indexed: 11/27/2022]
Abstract
Thrombosis is a major cause of morbidity and mortality and sonothrombolysis is a promising method for its treatment. However, the slow diffusion of the thrombolytic agents into the thrombus results in slow recanalization. Here, nanodroplet-coated microbubbles (NCMBs) are designed and fabricated and a two-step cavitation strategy is used to accelerate the thrombolysis. The first cavitation of the NCMBs, cavitation and collapse of the microbubbles induced by low frequency ultrasound, drives the nanodroplets on the shell into the thrombus, while the second cavitation, the phase-change and volume expansion of drug-loaded nanodroplets triggered by high frequency ultrasound, loosens the thrombus by the sono-porosity effect. This two-step cavitation of the NCMBs is verified using a fibrin agarose model, where a rapid diffusion of the thrombolytic agents is observed. Furthermore, the NCMBs reach much higher thrombolysis efficiency in both in vitro and proof-of-concept experiments performed with living mice. The nanodroplet-coated microbubbles are a promising diffusion medicines carrier for efficient drug delivery.
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Affiliation(s)
- Yunfan Pan
- State Key Laboratory of Tribology, Department of Mechanical Engineering, Tsinghua University, Beijing, 100084, China
| | - Yongjian Li
- State Key Laboratory of Tribology, Department of Mechanical Engineering, Tsinghua University, Beijing, 100084, China
| | - Yan Li
- State Key Laboratory of Tribology, Department of Mechanical Engineering, Tsinghua University, Beijing, 100084, China
| | - Xiaobing Zheng
- State Key Laboratory of Tribology, Department of Mechanical Engineering, Tsinghua University, Beijing, 100084, China
| | - Chenghong Zou
- School of Mechanical Engineering, University of Science and Technology Beijing, Beijing, 100083, China
| | - Jiang Li
- School of Mechanical Engineering, University of Science and Technology Beijing, Beijing, 100083, China
| | - Haosheng Chen
- State Key Laboratory of Tribology, Department of Mechanical Engineering, Tsinghua University, Beijing, 100084, China
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16
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Welch PJ, Li DS, Forest CR, Pozzo LD, Shi C. Perfluorocarbon nanodroplet size, acoustic vaporization, and inertial cavitation affected by lipid shell composition in vitro. THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2022; 152:2493. [PMID: 36319242 PMCID: PMC9812515 DOI: 10.1121/10.0014934] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 08/17/2022] [Accepted: 10/04/2022] [Indexed: 05/25/2023]
Abstract
Perfluorocarbon nanodroplets (PFCnDs) are ultrasound contrast agents that phase-transition from liquid nanodroplets to gas microbubbles when activated by laser irradiation or insonated with an ultrasound pulse. The dynamics of PFCnDs can vary drastically depending on the nanodroplet composition, including the lipid shell properties. In this paper, we investigate the effect of varying the ratio of PEGylated to non-PEGylated phospholipids in the outer shell of PFCnDs on the acoustic nanodroplet vaporization (liquid to gas phase transition) and inertial cavitation (rapid collapse of the vaporized nanodroplets) dynamics in vitro when insonated with focused ultrasound. Nanodroplets with a high concentration of PEGylated lipids had larger diameters and exhibited greater variance in size distribution compared to nanodroplets with lower proportions of PEGylated lipids in the lipid shell. PFCnDs with a lipid shell composed of 50:50 PEGylated to non-PEGylated lipids yielded the highest B-mode image intensity and duration, as well as the greatest pressure difference between acoustic droplet vaporization onset and inertial cavitation onset. We demonstrate that slight changes in lipid shell composition of PFCnDs can significantly impact droplet phase transitioning and inertial cavitation dynamics. These findings can help guide researchers to fabricate PFCnDs with optimized compositions for their specific applications.
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Affiliation(s)
- Phoebe J Welch
- George W. Woodruff School of Mechanical Engineering, Georgia Institute of Technology, Atlanta, Georgia 30332, USA
| | | | - Craig R Forest
- George W. Woodruff School of Mechanical Engineering, Georgia Institute of Technology, Atlanta, Georgia 30332, USA
| | - Lilo D Pozzo
- Department of Chemical Engineering, University of Washington, Seattle, Washington 98195, USA
| | - Chengzhi Shi
- George W. Woodruff School of Mechanical Engineering, Georgia Institute of Technology, Atlanta, Georgia 30332, USA
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17
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Choi W, Key J, Youn I, Lee H, Han S. Cavitation-assisted sonothrombolysis by asymmetrical nanostars for accelerated thrombolysis. J Control Release 2022; 350:870-885. [PMID: 36096365 DOI: 10.1016/j.jconrel.2022.09.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 08/30/2022] [Accepted: 09/05/2022] [Indexed: 11/18/2022]
Abstract
Sonothrombolysis with recombinant tissue plasminogen activator (rtPA) and microbubbles has been widely studied to enhance thrombolytic potential. Here, we report different sonothrombolysis strategy in nanoparticles using microbubbles cavitation. We found that different particles in shape exhibited different reactivity toward the cavitation, leading to a distinct sonothrombolytic potential. Two different gold nanoparticles in shape were functionalized with the rtPA: rtPA-functionalized gold nanospheres (NPt) and gold nanostars (NSt). NPt could not accelerate the thrombolytic potential with a sole acoustic stimulus. Importantly, NSt enhanced the potential with acoustic stimulus and microbubble-mediated cavitation, while NPt were not reactive to cavitation. Coadministration of NSt and microbubbles resulted in a dramatic reduction of the infarcts in a photothrombotic model and recovery in the cerebral blood flow. Given the synergistic effect and in vivo feasibility of this strategy, cavitation-assisted sonothrombolysis by asymmetrical NSt might be useful for treating acute ischemic stroke.
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Affiliation(s)
- Wonseok Choi
- Biomedical Research Division, Korea Institute of Science and Technology (KIST), Seoul 02792, Seongbuk-gu, Republic of Korea; Department of Biomedical Engineering, Yonsei University, Wonju 26493, Gangwon-do, Republic of Korea
| | - Jaehong Key
- Department of Biomedical Engineering, Yonsei University, Wonju 26493, Gangwon-do, Republic of Korea
| | - Inchan Youn
- Biomedical Research Division, Korea Institute of Science and Technology (KIST), Seoul 02792, Seongbuk-gu, Republic of Korea; Division of Bio-Medical Science & Technology, KIST School, Korea University of Science and Technology (UST), Seoul 02792, Seongbuk-gu, Republic of Korea; KHU-KIST Department of Converging Science and Technology, Kyung Hee University, Seoul 02447, Seongbuk-gu, Republic of Korea
| | - Hyojin Lee
- Biomedical Research Division, Korea Institute of Science and Technology (KIST), Seoul 02792, Seongbuk-gu, Republic of Korea; Division of Bio-Medical Science & Technology, KIST School, Korea University of Science and Technology (UST), Seoul 02792, Seongbuk-gu, Republic of Korea.
| | - Sungmin Han
- Biomedical Research Division, Korea Institute of Science and Technology (KIST), Seoul 02792, Seongbuk-gu, Republic of Korea; Division of Bio-Medical Science & Technology, KIST School, Korea University of Science and Technology (UST), Seoul 02792, Seongbuk-gu, Republic of Korea.
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18
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Zheng X, Pan Y, Zhang Y, Meng K, Zhou J, Wang X, Cui Y, Li J, Li Y, Chen H. Interventional Microbubble Enhanced Sonothrombolysis on Left Ventricular Assist Devices. ADVANCED SCIENCE (WEINHEIM, BADEN-WURTTEMBERG, GERMANY) 2022; 9:e2201291. [PMID: 35615977 PMCID: PMC9313509 DOI: 10.1002/advs.202201291] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/05/2022] [Revised: 04/27/2022] [Indexed: 06/15/2023]
Abstract
The left ventricular assist device (LVAD) is often used in the treatment of heart failure. However, 4% to 9% implanted LVAD will have thrombosis problem in one year, which is fatal to the patient's life. In this work, an interventional sonothrombolysis (IST) method is developed to realize the thrombolysis on LVAD. A pair of ultrasound transducer rings is installed on the shell of LVAD, and drug-loaded microbubbles are injected into the LVAD through the interventional method. The microbubbles are adhere on the thrombus with the coated thrombus-targeted drugs, and the thrombolytic drugs carried by the bubbles are brought into the thrombus by the cavitation of bubbles under the ultrasound. In a proof-of-concept experiment in a live sheep model, the thrombus on LVAD is dissolved in 30 min, without damages on LVADs and organs. This IST exhibits to be more efficient and safer compared with other thrombolysis methods on LVAD.
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Affiliation(s)
- Xiaobing Zheng
- State Key Laboratory of Tribology, Department of Mechanical Engineering, Tsinghua University, Beijing, 100084, China
| | - Yunfan Pan
- State Key Laboratory of Tribology, Department of Mechanical Engineering, Tsinghua University, Beijing, 100084, China
| | - Yuan Zhang
- School of Mechanical Engineering, University of Science and Technology Beijing, Beijing, 100083, China
| | - Kuilin Meng
- State Key Laboratory of Tribology, Department of Mechanical Engineering, Tsinghua University, Beijing, 100084, China
| | - Jianye Zhou
- Animal Experiment Center, Fuwai Hospital, Chinese Academy of Medical Sciences, Beijing, 100037, China
| | - Xin Wang
- Animal Experiment Center, Fuwai Hospital, Chinese Academy of Medical Sciences, Beijing, 100037, China
| | - Yongchun Cui
- Animal Experiment Center, Fuwai Hospital, Chinese Academy of Medical Sciences, Beijing, 100037, China
| | - Jiang Li
- School of Mechanical Engineering, University of Science and Technology Beijing, Beijing, 100083, China
| | - Yongjian Li
- State Key Laboratory of Tribology, Department of Mechanical Engineering, Tsinghua University, Beijing, 100084, China
| | - Haosheng Chen
- State Key Laboratory of Tribology, Department of Mechanical Engineering, Tsinghua University, Beijing, 100084, China
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19
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Wu H, Zhang B, Huang CC, Peng C, Zhou Q, Jiang X. Ultrasound-Guided Intravascular Sonothrombolysis With a Dual Mode Ultrasound Catheter: In Vitro Study. IEEE TRANSACTIONS ON ULTRASONICS, FERROELECTRICS, AND FREQUENCY CONTROL 2022; 69:1917-1925. [PMID: 35201986 PMCID: PMC9702596 DOI: 10.1109/tuffc.2022.3153929] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Thromboembolism in vessels often leads to stroke or heart attack and even sudden death unless brought under control. Sonothrombolysis based on ultrasound contrast agents has shown promising outcome in effective treatment of thromboembolism. Intravascular sonothrombolysis transducer was reported recently for unprecedented sonothrombolysis in vitro. However, it is necessary to provide an imaging guide during thrombolysis in clinical applications for optimal treatment efficiency. In this article, a dual mode ultrasound catheter was developed by combining a 16-MHz high-frequency element (imaging transducer) and a 220-kHz low-frequency element (treatment transducer) for sonothrombolysis in vitro. The treatment transducer was designed with a 20-layer PZT-5A stack with the aperture size of 1.2×1.2 mm2, and the imaging transducer with the aperture size of 1.2×1.2 mm2 was attached in front of the treatment transducer. Both transducers were assembled into a customized 2-lm 10-Fr catheter. In vitro experiment was carried out using a bovine blood clot. Imaging tests were conducted, showing that the backscattering signals can be obtained with a high signal-to-noise ratio (SNR) for the 16-MHz imaging transducer. Sonothrombolysis was performed successfully that the volume of clot was reduced significantly after the 30-min treatment. The size changes of clot were observed clearly using the 16-MHz M-mode imaging during the thrombolysis. The findings suggest that the proposed ultrasound-guided intravascular sonothrombolysis can be enhanced since the position of treatment transducer can be adjusted with the target at the clot due to the imaging guide.
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20
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Tang Y, Wu H, Klippel P, Zhang B, Huang HYS, Jing Y, Jiang X, Yao J. Deep thrombosis characterization using photoacoustic imaging with intravascular light delivery. Biomed Eng Lett 2022; 12:135-145. [PMID: 35529341 PMCID: PMC9046522 DOI: 10.1007/s13534-022-00216-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 01/18/2022] [Accepted: 01/22/2022] [Indexed: 11/28/2022] Open
Abstract
Venous thromboembolism (VTE) is a condition in which blood clots form within the deep veins of the leg or pelvis to cause deep vein thrombosis. The optimal treatment of VTE is determined by thrombus properties such as the age, size, and chemical composition of the blood clots. The thrombus properties can be readily evaluated by using photoacoustic computed tomography (PACT), a hybrid imaging modality that combines the rich contrast of optical imaging and deep penetration of ultrasound imaging. With inherent sensitivity to endogenous chromophores such as hemoglobin, multispectral PACT can provide composition information and oxygenation level in the clots. However, conventional PACT of clots relies on external light illumination, which provides limited penetration depth due to strong optical scattering of intervening tissue. In our study, this depth limitation is overcome by using intravascular light delivery with a thin optical fiber. To demonstrate in vitro blood clot characterization, clots with different acuteness and oxygenation levels were placed underneath ten-centimeter-thick chicken breast tissue and imaged using multiple wavelengths. Acoustic frequency analysis was performed on the received PA channel signals, and oxygenation level was estimated using multispectral linear spectral unmixing. The results show that, with intravascular light delivery, clot oxygenation level can be accurately measured, and the clot age can thus be estimated. In addition, we found that retracted and unretracted clots had different acoustic frequency spectrum. While unretracted clots had stronger high frequency components, retracted clots had much higher low frequency components due to densely packed red blood cells. The PACT characterization of the clots was consistent with the histology results and mechanical tests.
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Affiliation(s)
- Yuqi Tang
- Department of Biomedical Engineering, Duke University, Durham, NC USA
| | - Huaiyu Wu
- Department of Mechanical and Aerospace Engineering, North Carolina State University, Raleigh, NC USA
| | - Paul Klippel
- Graduate Program in Acoustics and Department of Biomedical Engineering, Pennsylvania State University, University Park, PA USA
| | - Bohua Zhang
- Department of Mechanical and Aerospace Engineering, North Carolina State University, Raleigh, NC USA
| | - Hsiao-Ying Shadow Huang
- Department of Mechanical and Aerospace Engineering, North Carolina State University, Raleigh, NC USA
| | - Yun Jing
- Graduate Program in Acoustics and Department of Biomedical Engineering, Pennsylvania State University, University Park, PA USA
| | - Xiaoning Jiang
- Department of Mechanical and Aerospace Engineering, North Carolina State University, Raleigh, NC USA
| | - Junjie Yao
- Department of Biomedical Engineering, Duke University, Durham, NC USA
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21
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Kim J, Bautista KJB, Deruiter RM, Goel L, Jiang X, Xu Z, Dayton PA. An Analysis of Sonothrombolysis and Cavitation for Retracted and Unretracted Clots Using Microbubbles Versus Low-Boiling-Point Nanodroplets. IEEE TRANSACTIONS ON ULTRASONICS, FERROELECTRICS, AND FREQUENCY CONTROL 2022; 69:711-719. [PMID: 34932475 PMCID: PMC9134349 DOI: 10.1109/tuffc.2021.3137125] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
The thrombolysis potential of low-boiling-point (-2 °C) perfluorocarbon phase-change nanodroplets (NDs) has previously been demonstrated on aged clots, and we hypothesized that this efficacy would extend to retracted clots. We tested this hypothesis by comparing sonothrombolysis of both unretracted and retracted clots using ND-mediated ultrasound (US+ND) and microbubble-mediated ultrasound (US+MB), respectively. Assessment data included clot mass reduction, cavitation detection, and cavitation cloud imaging in vitro. Acoustic parameters included a 7.9-MPa peak negative pressure and 180-cycle bursts with 5-Hz repetition (the corresponding duty cycle and time-averaged intensity of 0.09% and 1.87 W/cm2, respectively) based on prior studies. With these parameters, we observed a significantly reduced efficacy of US+MB in the retracted versus unretracted model (the averaged mass reduction rate from 1.83%/min to 0.54%/min). Unlike US+MB, US+ND exhibited less reduction of efficacy in the retracted model (from 2.15%/min to 1.04%/min on average). The cavitation detection results correlate with the sonothrombolysis efficacy results showing that both stable and inertial cavitation generated in a retracted clot by US+ND is higher than that by US+MB. We observed that ND-mediated cavitation shows a tendency to occur inside a clot, whereas MB-mediated cavitation occurs near the surface of a retracted clot, and this difference is more significant with retracted clots compared to unretracted clots. We conclude that ND-mediated sonothrombolysis outperforms MB-mediated therapy regardless of clot retraction, and this advantage of ND-mediated cavitation is emphasized for retracted clots. The primary mechanisms are hypothesized to be sustained cavitation level and cavitation clouds in the proximity of a retracted clot by US+ND.
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22
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Hendley SA, Bhargava A, Holland CK, Wool GD, Ahmed O, Paul JD, Bader KB. (More than) doubling down: Effective fibrinolysis at a reduced rt-PA dose for catheter-directed thrombolysis combined with histotripsy. PLoS One 2022; 17:e0261567. [PMID: 34982784 PMCID: PMC8726487 DOI: 10.1371/journal.pone.0261567] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Accepted: 12/04/2021] [Indexed: 02/07/2023] Open
Abstract
Deep vein thrombosis is a major source of morbidity and mortality worldwide. For acute proximal deep vein thrombosis, catheter-directed thrombolytic therapy is an accepted method for vessel recanalization. Thrombolytic therapy is not without risk, including the potential for hemorrhagic bleeding that increases with lytic dose. Histotripsy is a focused ultrasound therapy that generates bubble clouds spontaneously in tissue at depth. The mechanical activity of histotripsy increases the efficacy of thrombolytic therapy at doses consistent with current pharmacomechanical treatments for venous thrombosis. The objective of this study was to determine the influence of lytic dose on histotripsy-enhanced fibrinolysis. Human whole blood clots formed in vitro were exposed to histotripsy and a thrombolytic agent (recombinant tissue plasminogen activator, rt-PA) in a venous flow model perfused with plasma. Lytic was administered into the clot via an infusion catheter at concentrations ranging from 0 (control) to 4.54 μg/mL (a common clinical dose for catheter-directed thrombolysis). Following treatment, perfusate samples were assayed for markers of fibrinolysis, hemolysis, and intact red blood cells and platelets. Fibrinolysis was equivalent between the common clinical dose of rt-PA (4.54 μg/mL) and rt-PA at a reduction to one-twentieth of the common clinical dose (0.23 μg/mL) when combined with histotripsy. Minimal changes were observed in hemolysis for treatment arms with or without histotripsy, potentially due to clot damage from insertion of the infusion catheter. Likewise, histotripsy did not increase the concentration of red blood cells or platelets in the perfusate following treatment compared to rt-PA alone. At the highest lytic dose, a refined histotripsy exposure scheme was implemented to cover larger areas of the clot. The updated exposure scheme improved clot mass loss and fibrinolysis relative to administration of lytic alone. Overall, the data collected in this study indicate the rt-PA dose can be reduced by more than a factor of ten and still promote fibrinolysis when combined with histotripsy.
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Affiliation(s)
- Samuel A. Hendley
- Committee on Medical Physics, University of Chicago, Chicago, Illinois, United States of America
| | - Aarushi Bhargava
- Department of Radiology, University of Chicago, Chicago, Illinois, United States of America
| | - Christy K. Holland
- Department of Internal Medicine, University of Cincinnati, Cincinnati, Ohio, United States of America
- Department of Biomedical Engineering, University of Cincinnati, Cincinnati, Ohio, United States of America
| | - Geoffrey D. Wool
- Department of Pathology, University of Chicago, Chicago, Illinois, United States of America
| | - Osman Ahmed
- Department of Radiology, University of Chicago, Chicago, Illinois, United States of America
| | - Jonathan D. Paul
- Department of Medicine, University of Chicago, Chicago, Illinois, United States of America
| | - Kenneth B. Bader
- Committee on Medical Physics, University of Chicago, Chicago, Illinois, United States of America
- Department of Radiology, University of Chicago, Chicago, Illinois, United States of America
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23
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Masood U, Riaz R, Shah SU, Majeed AI, Abbas SR. Contrast enhanced sonothrombolysis using streptokinase loaded phase change nano-droplets for potential treatment of deep venous thrombosis. RSC Adv 2022; 12:26665-26672. [PMID: 36275167 PMCID: PMC9488110 DOI: 10.1039/d2ra04467f] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Accepted: 09/09/2022] [Indexed: 11/21/2022] Open
Abstract
Current thrombolytic therapies for deep venous thrombosis are limited due to the wide side effect profile. Contrast mediated sonothrombolysis is a promising approach for thrombus treatment. The current study examines the effectiveness of in vitro streptokinase (SK) loaded phase-change nanodroplet (PCND) mediated sonothrombolysis at 7 MHz for the diagnosis of deep venous thrombosis. Lecithin shell and perfluorohexane core nanodroplets were prepared via the thin-film hydration method and morphologically characterized. Sonothrombolysis was performed at 7 MHz at different mechanical indexes of samples i.e., only sonothrombolysis, PCND mediated sonothrombolysis, sonothrombolysis with SK and SK loaded PCND mediated sonothrombolysis. Thrombolysis efficacy was assessed by measuring clot weight changes during 30 min US exposure, recording the mean gray intensity from the US images of the clot by computer software ImageJ, and spectrophotometric quantification of the hemoglobin in the clot lysate. In 15 minutes of sonothrombolysis performed at high mechanical index (0.9 and 1.2), SK loaded PCNDs showed a 48.61% and 74.29% reduction of mean gray intensity. At 0.9 and 1.2 MI, 86% and 92% weight loss was noted for SK-loaded PCNDs in confidence with spectrophotometric results. A significant difference (P < 0.05) was noted for SK-loaded PCND mediated sonothrombolysis compared to other groups. Loading of SK inside the PCNDs enhanced the efficacy of sonothrombolysis. An increase in MI and time also increased the efficacy of sonothrombolysis. This in vitro study showed the potential use of SK-loaded perfluorohexane core PCNDs as sonothrombolytic agents for deep venous thrombosis. Contrast enhanced sonothrombolysis using streptokinase loaded phase change nano-droplets.![]()
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Affiliation(s)
- Usama Masood
- Department of Industrial Biotechnology, Atta-Ur-Rahman School of Applied Biosciences (ASAB), National University of Sciences and Technology, Islamabad, Pakistan
| | - Ramish Riaz
- Department of Industrial Biotechnology, Atta-Ur-Rahman School of Applied Biosciences (ASAB), National University of Sciences and Technology, Islamabad, Pakistan
| | - Saeed Ullah Shah
- Department of Cardiology, Shifa International Hospitals Ltd., Islamabad, Pakistan
| | - Ayesha Isani Majeed
- Department of Radiology, Pakistan Institute of Medical Sciences, Islamabad, Pakistan
| | - Shah Rukh Abbas
- Department of Industrial Biotechnology, Atta-Ur-Rahman School of Applied Biosciences (ASAB), National University of Sciences and Technology, Islamabad, Pakistan
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Stocker GE, Shi J, Ives K, Maxwell AD, Dayton PA, Jiang X, Xu Z, Owens GE. In Vivo Porcine Aged Deep Vein Thrombosis Model for Testing Ultrasound-based Thrombolysis Techniques. ULTRASOUND IN MEDICINE & BIOLOGY 2021; 47:3447-3457. [PMID: 34593277 PMCID: PMC8578380 DOI: 10.1016/j.ultrasmedbio.2021.08.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 08/23/2021] [Accepted: 08/23/2021] [Indexed: 06/13/2023]
Abstract
As blood clots age, many thrombolytic techniques become less effective. To fully evaluate these techniques for potential clinical use, a large animal aged-clot model is needed. Previous minimally invasive attempts to allow clots to age in an in vivo large animal model were unsuccessful because of the clot clearance associated with relatively high level of cardiac health of readily available research pigs. Prior models have thus subsequently used invasive surgical techniques with the associated morbidity, animal stress and cost. We propose a method for forming sub-acute venous blood clots in an in-vivo porcine model. The age of the clots can be controlled and varied. By using an intravenous scaffold to anchor the clot to the vessel wall during the aging process, we can show that sub-acute clots can consistently be formed with a minimally invasive, percutaneous approach. The clot formed in this study remained intact for at least 1 wk in all subjects. Therefore, we established a new minimally invasive, large animal aged-clot model for evaluation of thrombolytic techniques.
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Affiliation(s)
- Greyson E Stocker
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, Michigan, USA.
| | - Jiaqi Shi
- Department of Pathology and Clinical Laboraties, Rogel Cancer Center, University of Michigan, Ann Arbor, Michigan, USA
| | - Kimberly Ives
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, Michigan, USA
| | - Adam D Maxwell
- Department of Urology, University of Washington School of Medicine, Seattle, Washington, USA
| | - Paul A Dayton
- Joint Department of Biomedical Engineering, The University of North Carolina at Chapel Hill and North Carolina State University, Chapel Hill, North Carolina, USA
| | - Xiaoning Jiang
- Department of Mechanical and Aerospace Engineering, North Carolina State University, Raleigh, North Carolina, USA
| | - Zhen Xu
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, Michigan, USA
| | - Gabe E Owens
- Department of Pediatric Cardiology, University of Michigan, Ann Arbor, Michigan, USA
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Durham PG, Dayton PA. Applications of sub-micron low-boiling point phase change contrast agents for ultrasound imaging and therapy. Curr Opin Colloid Interface Sci 2021. [DOI: 10.1016/j.cocis.2021.101498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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26
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Goel L, Wu H, Zhang B, Kim J, Dayton PA, Xu Z, Jiang X. Safety Evaluation of a Forward-Viewing Intravascular Transducer for Sonothrombolysis: An in Vitro and ex Vivo Study. ULTRASOUND IN MEDICINE & BIOLOGY 2021; 47:3231-3239. [PMID: 34446331 PMCID: PMC8487993 DOI: 10.1016/j.ultrasmedbio.2021.07.018] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 06/14/2021] [Accepted: 07/23/2021] [Indexed: 05/03/2023]
Abstract
Recent in vitro work has revealed that a forward-viewing intravascular (FVI) transducer has sonothrombolysis applications. However, the safety of this device has yet to be evaluated. In this study, we evaluated the safety of this device in terms of tissue heating, vessel damage and particle debris size during sonothrombolysis using microbubbles or nanodroplets with tissue plasminogen activator, in both retracted and unretracted blood clots. The in vitro and ex vivo sonothrombolysis tests using FVI transducers revealed a temperature rise of less than 1°C, no vessel damage as assessed by histology and no downstream clot particles >500 µm. These in vitro and ex vivo results indicate that the FVI transducer poses minimal risk for sonothrombolysis applications and should be further evaluated in animal models.
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Affiliation(s)
- Leela Goel
- Department of Mechanical and Aerospace Engineering, North Carolina State University, Raleigh, North Carolina, USA; Joint Department of Biomedical Engineering, University of North Carolina at Chapel Hill and North Carolina State University, Raleigh, North Carolina, USA
| | - Huaiyu Wu
- Department of Mechanical and Aerospace Engineering, North Carolina State University, Raleigh, North Carolina, USA
| | - Bohua Zhang
- Department of Mechanical and Aerospace Engineering, North Carolina State University, Raleigh, North Carolina, USA
| | - Jinwook Kim
- Joint Department of Biomedical Engineering, University of North Carolina at Chapel Hill and North Carolina State University, Raleigh, North Carolina, USA
| | - Paul A Dayton
- Joint Department of Biomedical Engineering, University of North Carolina at Chapel Hill and North Carolina State University, Raleigh, North Carolina, USA
| | - Zhen Xu
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, Michigan, USA
| | - Xiaoning Jiang
- Department of Mechanical and Aerospace Engineering, North Carolina State University, Raleigh, North Carolina, USA.
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Kim H, Kim J, Wu H, Zhang B, Dayton PA, Jiang X. A multi-pillar piezoelectric stack transducer for nanodroplet mediated intravascular sonothrombolysis. ULTRASONICS 2021; 116:106520. [PMID: 34274742 DOI: 10.1016/j.ultras.2021.106520] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 05/24/2021] [Accepted: 07/05/2021] [Indexed: 06/13/2023]
Abstract
We aim to develop a nanodroplet (ND)-mediated intravascular ultrasound (US) transducer for deep vein thrombosis treatments. The US device, having an efficient forward directivity of the acoustic beam, is capable of expediting the clot dissolution rate by activating cavitation of NDs injected onto a thrombus. We designed and prototyped a multi-pillar piezoelectric stack (MPPS) transducer composed of four piezoelectric stacks. Each stack was made of five layers of PZT-4 plates, having a dimension of 0.85 × 0.85 × 0.2 mm3. The transducer was characterized by measuring the electrical impedance and acoustic pressure, compared to simulation results. Next, in-vitro tests were conducted in a blood flow mimicking system using the transducer equipped with an ND injecting tube. The miniaturized transducer, having an aperture size of 2.8 mm, provided a high mechanical index of 1.52 and a relatively wide focal zone of 3.4 mm at 80 Vpp, 0.96 MHz electric input. The mass-reduction rate of the proposed method (NDs + US) was assessed to be 4.1 and 4.6 mg/min with and without the flow model, respectively. The rate was higher than that (1.3-2.7 mg/min) of other intravascular ultrasound modalities using micron-sized bubble agents. The ND-mediated intravascular sonothrombolysis using MPPS transducers was demonstrated with an unprecedented lysis rate, which may offer a new clinical option for DVT treatments. The MPPS transducer generated a high acoustic pressure (~3.1 MPa) at a distance of approximately 2.2 wavelengths from the small aperture, providing synergistic efficacy with nanodroplets for thrombolysis without thrombolytic agents.
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Affiliation(s)
- Howuk Kim
- The Department of Mechanical and Aerospace Engineering at North Carolina State University, Raleigh, NC 27695, USA
| | - Jinwook Kim
- The Joint Department of Biomedical Engineering, The University of North Carolina at Chapel Hill and North Carolina State University, Chapel Hill, NC 27599, USA
| | - Huaiyu Wu
- The Department of Mechanical and Aerospace Engineering at North Carolina State University, Raleigh, NC 27695, USA
| | - Bohua Zhang
- The Department of Mechanical and Aerospace Engineering at North Carolina State University, Raleigh, NC 27695, USA
| | - Paul A Dayton
- The Joint Department of Biomedical Engineering, The University of North Carolina at Chapel Hill and North Carolina State University, Chapel Hill, NC 27599, USA
| | - Xiaoning Jiang
- The Department of Mechanical and Aerospace Engineering at North Carolina State University, Raleigh, NC 27695, USA.
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Zhang B, Wu H, Goel L, Kim H, Peng C, Kim J, Dayton PA, Gao Y, Jiang X. Magneto-sonothrombolysis with combination of magnetic microbubbles and nanodroplets. ULTRASONICS 2021; 116:106487. [PMID: 34119875 PMCID: PMC8645658 DOI: 10.1016/j.ultras.2021.106487] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 05/25/2021] [Accepted: 05/31/2021] [Indexed: 05/07/2023]
Abstract
This paper reports a novel technique using the rotational magnetic field oscillation and low-intensity sub-megahertz ultrasound stimulation of magnetic microbubbles (MMBs) to promote the nanodroplets (NDs) phase transition and improve the permeation of NDs into the blood clot fibrin network to enhance the sonothrombolysis efficiency. In this study, the influence of different treatment methods with a combination of MMBs and NDs on the thrombolysis rate of both unretracted and retracted clots were investigated, including the stable and inertial cavitation, tPA effects, MMBs/NDs concentration ratio, sonication factors (input voltage, duty cycle) and rotational magnetic field factors (flux density, frequency). We demonstrated that tPA-mediated magneto-sonothrombolysis in combining NDs with MMBs could significantly enhance in vitro lysis of both unretracted clots (85 ± 8.3%) and retracted clots (57 ± 6.5%) in a flow model with 30 min treatment. The results showed that the combination of MMBs and NDs substantially improves in vitro lysis of blood clots with an unprecedented lysis rate.
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Affiliation(s)
- Bohua Zhang
- Department of Mechanical and Aerospace Engineering, North Carolina State University, Raleigh, NC 27695, USA
| | - Huaiyu Wu
- Department of Mechanical and Aerospace Engineering, North Carolina State University, Raleigh, NC 27695, USA
| | - Leela Goel
- Department of Mechanical and Aerospace Engineering, North Carolina State University, Raleigh, NC 27695, USA; The Joint Department of Biomedical Engineering, The University of North Carolina at Chapel Hill and North Carolina State University, Chapel Hill, NC 27599, USA
| | - Howuk Kim
- Department of Mechanical and Aerospace Engineering, North Carolina State University, Raleigh, NC 27695, USA
| | - Chang Peng
- Department of Mechanical and Aerospace Engineering, North Carolina State University, Raleigh, NC 27695, USA
| | - Jinwook Kim
- The Joint Department of Biomedical Engineering, The University of North Carolina at Chapel Hill and North Carolina State University, Chapel Hill, NC 27599, USA
| | - Paul A Dayton
- The Joint Department of Biomedical Engineering, The University of North Carolina at Chapel Hill and North Carolina State University, Chapel Hill, NC 27599, USA
| | - Yu Gao
- Institute of Advanced Materials, Nanjing University of Posts and Telecommunications, Nanjing 210023, China
| | - Xiaoning Jiang
- Department of Mechanical and Aerospace Engineering, North Carolina State University, Raleigh, NC 27695, USA.
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29
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Xu M, Yim W, Zhou J, Zhou J, Jin Z, Moore C, Borum R, Jorns A, Jokerst JV. The Application of Organic Nanomaterials for Bioimaging, Drug Delivery, and Therapy: Spanning Various Domains. IEEE NANOTECHNOLOGY MAGAZINE 2021. [DOI: 10.1109/mnano.2021.3081758] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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30
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El Kadi S, Qian L, Zeng P, Lof J, Stolze E, Xie F, van Rossum AC, Kamp O, Everbach C, Porter TR. Efficacy of Sonothrombolysis Using Acoustically Activated Perflutren Nanodroplets versus Perflutren Microbubbles. ULTRASOUND IN MEDICINE & BIOLOGY 2021; 47:1814-1825. [PMID: 33896679 DOI: 10.1016/j.ultrasmedbio.2021.03.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 03/17/2021] [Accepted: 03/17/2021] [Indexed: 06/12/2023]
Abstract
Nanoscale-diameter liquid droplets from commercially available microbubbles may optimize thrombus permeation and subsequent thrombus dissolution (TD). Thrombi were made using fresh porcine arterial whole blood and placed in an in vitro vascular simulation. A diagnostic ultrasound probe in contact with a tissue-mimicking phantom tested intermittent high-mechanical-index (HMI) fundamental multipulse (focused ultrasound [FUS], 1.8 MHz) versus harmonic single-pulse (HUS, 1.3 MHz) modes during a 10-min infusion of Definity nanodroplets (DNDs), Definity microbubbles (DMBs) or saline. The ability of FUS and intravenous DNDs to improve epicardial and microvascular flow was then tested in four pigs with left anterior descending thrombotic occlusion. Sixty in vitro thrombi were tested, 20 in each group. Percentage TD was significantly higher for DND-treated thrombi than DMB-treated thrombi and controls (DNDs: 42.4%, DMBs: 26.7%, saline: 15.0%; p < 0.0001 vs. control). The highest %TD was seen in the HMI FUS-treated DND group (51 ± 17% TD). HMI FUS detected droplet activation within the risk area in three of four pigs with left anterior descending thrombotic occlusion and re-canalized the epicardial vessel in two. DNDs with intermittent diagnostic HMI ultrasound resulted in significantly more intravascular TD than DMBs and have potential for coronary and risk area thrombolysis.
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Affiliation(s)
- Soufiane El Kadi
- Department of Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam UMC Location VUmc, Amsterdam, The Netherlands; Department of Cardiovascular Medicine, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Lijun Qian
- Department of Cardiovascular Medicine, University of Nebraska Medical Center, Omaha, Nebraska, USA; Department of Cardiology, First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Ping Zeng
- Department of Cardiovascular Medicine, University of Nebraska Medical Center, Omaha, Nebraska, USA; Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - John Lof
- Department of Cardiovascular Medicine, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Elizabeth Stolze
- Department of Cardiovascular Medicine, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Feng Xie
- Department of Cardiovascular Medicine, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Albert C van Rossum
- Department of Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam UMC Location VUmc, Amsterdam, The Netherlands
| | - Otto Kamp
- Department of Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam UMC Location VUmc, Amsterdam, The Netherlands
| | - Carr Everbach
- Department of Engineering, Swarthmore College, Swarthmore, Pennsylvania, USA
| | - Thomas R Porter
- Department of Cardiovascular Medicine, University of Nebraska Medical Center, Omaha, Nebraska, USA.
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31
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Jangjou A, Meisami AH, Jamali K, Niakan MH, Abbasi M, Shafiee M, Salehi M, Hosseinzadeh A, Amani AM, Vaez A. The promising shadow of microbubble over medical sciences: from fighting wide scope of prevalence disease to cancer eradication. J Biomed Sci 2021; 28:49. [PMID: 34154581 PMCID: PMC8215828 DOI: 10.1186/s12929-021-00744-4] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Accepted: 06/10/2021] [Indexed: 12/29/2022] Open
Abstract
Microbubbles are typically 0.5-10 μm in size. Their size tends to make it easier for medication delivery mechanisms to navigate the body by allowing them to be swallowed more easily. The gas included in the microbubble is surrounded by a membrane that may consist of biocompatible biopolymers, polymers, surfactants, proteins, lipids, or a combination thereof. One of the most effective implementation techniques for tiny bubbles is to apply them as a drug carrier that has the potential to activate ultrasound (US); this allows the drug to be released by US. Microbubbles are often designed to preserve and secure medicines or substances before they have reached a certain area of concern and, finally, US is used to disintegrate microbubbles, triggering site-specific leakage/release of biologically active drugs. They have excellent therapeutic potential in a wide range of common diseases. In this article, we discussed microbubbles and their advantageous medicinal uses in the treatment of certain prevalent disorders, including Parkinson's disease, Alzheimer's disease, cardiovascular disease, diabetic condition, renal defects, and finally, their use in the treatment of various forms of cancer as well as their incorporation with nanoparticles. Using microbubble technology as a novel carrier, the ability to prevent and eradicate prevalent diseases has strengthened the promise of effective care to improve patient well-being and life expectancy.
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Affiliation(s)
- Ali Jangjou
- Department of Emergency Medicine, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Amir Hossein Meisami
- Department of Emergency Medicine, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Kazem Jamali
- Trauma Research Center, Shahid Rajaee (Emtiaz) Trauma Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Hadi Niakan
- Trauma Research Center, Shahid Rajaee (Emtiaz) Trauma Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Milad Abbasi
- Department of Medical Nanotechnology, School of Advanced Medical Sciences and Technologies, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mostafa Shafiee
- Department of Medical Nanotechnology, School of Advanced Medical Sciences and Technologies, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Majid Salehi
- Department of Tissue Engineering, School of Medicine, Shahroud University of Medical Sciences, Shahroud, Iran
- Tissue Engineering and Stem Cells Research Center, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Ahmad Hosseinzadeh
- Thoracic and Vascular Surgery Research Center, Nemazee Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ali Mohammad Amani
- Department of Medical Nanotechnology, School of Advanced Medical Sciences and Technologies, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ahmad Vaez
- Department of Tissue Engineering and Applied Cell Sciences, School of Advanced Medical Sciences and Technologies, Shiraz University of Medical Sciences, Shiraz, Iran
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