Oscillatory interaction between bubbles and confining microvessels and its implications on clinical vascular injuries of shock-wave lithotripsy

Experimental study on damage mechanism of blood vessel by cavitation bubbles

Ultrasound-induced cavitation in blood vessels is a common scenario in medical procedures. This paper focuses on understanding the mechanism of microscopic damage to vessel walls caused by the evolution of cavitation bubbles within the vessels. In this study, cavitation bubbles were generated using the low-voltage discharge method in 0.9% sodium chloride saline, and vessel models with wall thicknesses ranging from 0.7 mm to 2 mm were made using a 3D laminating process. The interaction between cavitation bubbles and vessel models with different wall thicknesses was observed using a combination of high-speed photography. Results show that cavitation bubble morphology and collapse time increased and then stabilized as the vessel wall thickness increased. When the cavitation bubble was located in vessel axial line, pair of opposing micro-jets were formed along the axis of the vessel, and the peak of micro-jet velocity decreased with increasing wall thickness. However, when the cavitation bubble deviated from the vessel model center, no micro-jet towards the vessel model wall was observed. Further analysis of the vessel wall deformation under varying distances from the cavitation bubble to the vessel wall revealed that the magnitude of vessel wall stretch due to the cavitation bubble expansion was greater than that of the contraction. A comparative analysis of the interaction of between the cavitation bubble and different forms of elastic membranes showed that the oscillation period of the cavitation bubble under the influence of elastic vessel model was lower than the elastic membrane. Furthermore, the degree of deformation of elastic vessel models under the expansion of the cavitation bubble was smaller than that of elastic membranes, whereas the degree of deformation of elastic vessel models in the contraction phase of the cavitation bubble was larger than that of elastic membranes. These new findings provide important theoretical insights into the microscopic mechanisms of blood vessel potential damage caused by ultrasound-induced cavitation bubble, as well as cavitation in pipelines in hydrodynamic systems.

Opening doors with ultrasound and microbubbles: Beating biological barriers to promote drug delivery

Apart from its clinical use in imaging, ultrasound has been thoroughly investigated as a tool to enhance drug delivery in a wide variety of applications. Therapeutic ultrasound, as such or combined with cavitating nuclei or microbubbles, has been explored to cross or permeabilize different biological barriers. This ability to access otherwise impermeable tissues in the body makes the combination of ultrasound and therapeutics very appealing to enhance drug delivery in situ. This review gives an overview of the most important biological barriers that can be tackled using ultrasound and aims to provide insight on how ultrasound has shown to improve accessibility as well as the biggest hurdles. In addition, we discuss the clinical applicability of therapeutic ultrasound with respect to the main challenges that must be addressed to enable the further progression of therapeutic ultrasound towards an effective, safe and easy-to-use treatment tailored for drug delivery in patients.

The inertial terms in equations of motion for bubbles in tubular vessels or between plates

Equations resembling the Rayleigh-Plesset and Keller-Miksis equations are frequently used to model bubble dynamics in confined spaces, using the standard inertial term RR+3R([middle dot]) (2)/2, where R is the bubble radius. This practice has been widely assumed to be defensible if the bubble is much smaller than the radius of the confining vessel. This paper questions this assumption, and provides a simple rigid wall model for worst-case quantification of the effect on the inertial term of the specific confinement geometry. The relevance to a range of scenarios (including bubbles confined in microfluidic devices; or contained in test chambers for insonification or imaging; or in blood vessels) is discussed.

Ultrasound contrast microbubbles in imaging and therapy: physical principles and engineering

Microbubble contrast agents and the associated imaging systems have developed over the past 25 years, originating with manually-agitated fluids introduced for intra-coronary injection. Over this period, stabilizing shells and low diffusivity gas materials have been incorporated in microbubbles, extending stability in vitro and in vivo. Simultaneously, the interaction of these small gas bubbles with ultrasonic waves has been extensively studied, resulting in models for oscillation and increasingly sophisticated imaging strategies. Early studies recognized that echoes from microbubbles contained frequencies that are multiples of the microbubble resonance frequency. Although individual microbubble contrast agents cannot be resolved-given that their diameter is on the order of microns-nonlinear echoes from these agents are used to map regions of perfused tissue and to estimate the local microvascular flow rate. Such strategies overcome a fundamental limitation of previous ultrasound blood flow strategies; the previous Doppler-based strategies are insensitive to capillary flow. Further, the insonation of resonant bubbles results in interesting physical phenomena that have been widely studied for use in drug and gene delivery. Ultrasound pressure can enhance gas diffusion, rapidly fragment the agent into a set of smaller bubbles or displace the microbubble to a blood vessel wall. Insonation of a microbubble can also produce liquid jets and local shear stress that alter biological membranes and facilitate transport. In this review, we focus on the physical aspects of these agents, exploring microbubble imaging modes, models for microbubble oscillation and the interaction of the microbubble with the endothelium.

Ultrasonic excitation of a bubble inside a deformable tube: implications for ultrasonically induced hemorrhage

Various independent investigations indicate that the presence of microbubbles within blood vessels may increase the likelihood of ultrasound-induced hemorrhage. To explore potential damage mechanisms, an axisymmetric coupled finite element and boundary element code was developed and employed to simulate the response of an acoustically excited bubble centered within a deformable tube. As expected, the tube mitigates the expansion of the bubble. The maximum tube dilation and maximum hoop stress were found to occur well before the bubble reached its maximum radius. Therefore, it is not likely that the expanding low pressure bubble pushes the tube wall outward. Instead, simulation results indicate that the tensile portion of the acoustic excitation plays a major role in tube dilation and thus tube rupture. The effects of tube dimensions (tube wall thickness 1-5 microm), material properties (Young's modulus 1-10 MPa), ultrasound frequency (1-10 MHz), and pressure amplitude (0.2-1.0 MPa) on bubble response and tube dilation were investigated. As the tube thickness, tube radius, and acoustic frequency decreased, the maximum hoop stress increased, indicating a higher potential for tube rupture and hemorrhage.

Transmitted ultrasound pressure variation in micro blood vessel phantoms

Silica, cellulose and polymethylmethacrylate tubes with inner diameters of ten to a few hundred microns are commonly used as blood vessel phantoms in in vitro studies of microbubble or nanodroplet behavior during insonation. However, a detailed investigation of the ultrasonic fields within these micro-tubes has not yet been performed. This work provides a theoretical analysis of the ultrasonic fields within micro-tubes. Numerical results show that for the same tube material, the interaction between the micro-tube and megaHertz-frequency ultrasound may vary drastically with incident frequency, tube diameter and wall thickness. For 10 MHz ultrasonic insonation of a polymethylmethacrylate (PMMA) tube with an inner diameter of 195 microm and an outer diameter of 260 microm, the peak pressure within the tube can be up to 300% of incident pressure amplitude. However, using 1 MHz ultrasound and a silica tube with an inner diameter of 12 microm and an outer diameter of 50 microm, the peak pressure within the tube is only 12% of the incident pressure amplitude and correspondingly, the spatial-average-time-average intensity within the tube is only 1% of the incident intensity.

Effect of an entrained air bubble on the acoustics of an ink channel

Piezo-driven inkjet systems are very sensitive to air entrapment. The entrapped air bubbles grow by rectified diffusion in the ink channel and finally result in nozzle failure. Experimental results on the dynamics of fully grown air bubbles are presented. It is found that the bubble counteracts the pressure buildup necessary for the droplet formation. The channel acoustics and the air bubble dynamics are modeled. For good agreement with the experimental data it is crucial to include the confined geometry into the model: The air bubble acts back on the acoustic field in the channel and thus on its own dynamics. This two-way coupling limits further bubble growth and thus determines the saturation size of the bubble.

The application of microbubbles for targeted drug delivery

Interest in microbubbles as vehicles for drug delivery has grown in recent years, due in part to characteristics that make them well suited for this role and in part to the need the for localized delivery of drugs in a number of applications. Microbubbles are inherently small, allowing transvascular passage, they can be functionalized for targeted adhesion, and can be acoustically driven, which facilitates ultrasound detection, production of bioeffects and controlled release of the cargo. This article provides an overview of related microbubble biofluid mechanics and reviews recent developments in the application of microbubbles for targeted drug delivery. Additionally, related advances in non-bubble microparticles for drug delivery are briefly described in the context of targeted adhesion.

The natural frequency of nonlinear oscillation of ultrasound contrast agents in microvessels

Ultrasound contrast agents (UCAs) are under intensive investigation for their applications in physiological and molecular imaging and drug delivery. Prediction of the natural frequency of the oscillation of UCAs in microvessels has drawn increasing attention. To our knowledge, the existing models to predict the natural frequency of oscillation of UCAs in microvessels all apply the linear approximation and treat the blood vessel wall as a rigid boundary. In the potential applications of ultrasound imaging drug and gene delivery, the compliance of small vessels may play an important role in the bubble's oscillation. The goal of this work is to provide a lumped-parameter model to study the natural frequency of nonlinear oscillation of UCAs in microvessels. Three types of the blood vessel conditions have been considered: i.e., rigid vessels, normal compliable vessels and vessels with increasing stiffness that could correspond to tumor vasculature. The corresponding bubble oscillation frequencies in vessels with a radius less than 100 microm are examined in detail. When a bubble with a radius of 4 microm is confined in a compliable vessel (inner radius 5 microm and length 100 microm), the natural frequency of bubble oscillation increases by a factor of 1.7 compared with a bubble in an unbounded field. The natural frequency of oscillation of a bubble in a compliable vessel increases with decreasing vessel size while decreasing with increasing values of vessel rigidity. This model suggests that contrast agent size, blood vessel size distribution and the type of vasculature should comprehensively be considered for choosing the transmitted frequency in ultrasound contrast imaging and drug delivery.

Acoustic response of compliable microvessels containing ultrasound contrast agents

The existing models of the dynamics of ultrasound contrast agents (UCAs) have largely been focused on an UCA surrounded by an infinite liquid. Preliminary investigations of a microbubble's oscillation in a rigid tube have been performed using linear perturbation, under the assumption that the tube diameter is significantly larger than the UCA diameter. In the potential application of drug and gene delivery, it may be desirable to fragment the agent shell within small blood vessels and in some cases to rupture the vessel wall, releasing drugs and genes at the site. The effect of a compliant small blood vessel on the UCA's oscillation and the microvessel's acoustic response are unknown. The aim of this work is to propose a lumped-parameter model to study the interaction of a microbubble oscillation and compliable microvessels. Numerical results demonstrate that in the presence of UCAs, the transmural pressure through the blood vessel substantially increases and thus the vascular permeability is predicted to be enhanced. For a microbubble within an 8 to 40 microm vessel with a peak negative pressure of 0.1 MPa and a centre frequency of 1 MHz, small changes in the microbubble oscillation frequency and maximum diameter are observed. When the ultrasound pressure increases, strong nonlinear oscillation occurs, with an increased circumferential stress on the vessel. For a compliable vessel with a diameter equal to or greater than 8 microm, 0.2 MPa PNP at 1 MHz is predicted to be sufficient for microbubble fragmentation regardless of the vessel diameter; however, for a rigid vessel 0.5 MPa PNP at 1 MHz may not be sufficient to fragment the bubbles. For a centre frequency of 1 MHz, a peak negative pressure of 0.5 MPa is predicted to be sufficient to exceed the stress threshold for vascular rupture in a small (diameter less than 15 microm) compliant vessel. As the vessel or surrounding tissue becomes more rigid, the UCA oscillation and vessel dilation decrease; however the circumferential stress is predicted to increase. Decreasing the vessel size or the centre frequency increases the circumferential stress. For the two frequencies considered in this work, the circumferential stress does not scale as the inverse of the square root of the acoustic frequency va as in the mechanical index, but rather has a stronger frequency dependence, 1/va.