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Ultrasound-enhanced thrombolysis at 20 kHz with air-filled and perfluorocarbon-filled contrast bispheres

2000; Elsevier BV; Volume: 13; Issue: 11 Linguagem: Inglês

10.1067/mje.2000.107006

1097-6795

Milind R. Dhond, Thanh Tan Nguyen, C. Terrance Dolan, Greg Pulido, William J. Bommer,

Atrial Fibrillation Management and Outcomes

Ultrasound (US) at low frequencies has been shown to enhance clot lysis by itself and in the presence of urokinase (UK). The comparative effects of air-filled versus perfluorocarbon-filled polymer bispheres in enhancing this effect have not been previously demonstrated.Freshly drawn human blood was incubated at 37 degrees C for 2 hours, and the subsequent formed clot was dried and weighed. It was then exposed to saline control, saline + UK (10,000 IU), saline + UK + US, saline + UK + US + low shell-strength polymer bispheres (PB1), saline + UK + US + high shell-strength polymer bispheres (PB2), and perfluorocarbon-filled high shell-strength polymer bipsheres (PB3) for a total of 6 minutes. Clots were removed and weighed to determine the percentage of thrombolysis.The percentage of clot lysis for each study group was as follows: saline 18.5% +/- 4%, US alone 22.2% +/- 5%, UK alone 21.9% +/- 4%, US+UK 32.2% +/- 8% (P <.05 compared with UK alone), US+UK+PB1 36.9% +/- 8%, US+UK+PB2 34.3% +/- 8%, and US+UK+PB3 45.0% +/- 11% (P <.05 compared with US+UK, P <.05 compared with US+UK+PB2).Ultrasound at 20 kHz significantly enhances clot lysis. The addition of perfluorocarbon-filled bispheres increased this effect more significantly than did the addition of air-filled polymer bispheres.