Diagnostic Ultrasound Induced Inertial Cavitation to Non-Invasively Restore Coronary and Microvascular Flow in Acute Myocardial Infarction

Feng Xie, Shunji Gao, Juefei Wu, John Lof, Stanley Radio, Francois Vignon, William Shi, Jeffry Powers, Evan C Unger, E. Carr Everbach, Jinjin Liu, Thomas R. Porter

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

Ultrasound induced cavitation has been explored as a method of dissolving intravascular and microvascular thrombi in acute myocardial infarction. The purpose of this study was to determine the type of cavitation required for success, and whether longer pulse duration therapeutic impulses (sustaining the duration of cavitation) could restore both microvascular and epicardial flow with this technique. Accordingly, in 36 hyperlipidemic atherosclerotic pigs, thrombotic occlusions were induced in the mid-left anterior descending artery. Pigs were then randomized to either a) 1/2 dose tissue plasminogen activator (0.5 mg/kg) alone; or same dose plasminogen activator and an intravenous microbubble infusion with either b) guided high mechanical index short pulse (2.0 MI; 5 usec) therapeutic ultrasound impulses; or c) guided 1.0 mechanical index long pulse (20 usec) impulses. Passive cavitation detectors indicated the high mechanical index impulses (both long and short pulse duration) induced inertial cavitation within the microvasculature. Epicardial recanalization rates following randomized treatments were highest in pigs treated with the long pulse duration therapeutic impulses (83% versus 59% for short pulse, and 49% for tissue plasminogen activator alone; p<0.05). Even without epicardial recanalization, however, early microvascular recovery occurred with both short and long pulse therapeutic impulses (p<0.005 compared to tissue plasminogen activator alone), and wall thickening improved within the risk area only in pigs treated with ultrasound and microbubbles. We conclude that although short pulse duration guided therapeutic impulses from a diagnostic transducer transiently improve microvascular flow, long pulse duration therapeutic impulses produce sustained epicardial and microvascular re-flow in acute myocardial infarction.

Original languageEnglish (US)
Article numbere69780
JournalPLoS One
Volume8
Issue number7
DOIs
StatePublished - Jul 29 2013
Externally publishedYes

Fingerprint

myocardial infarction
Cavitation
Ultrasonography
Ultrasonics
Myocardial Infarction
t-plasminogen activator
Tissue Plasminogen Activator
therapeutics
duration
microbubbles
Swine
swine
Microbubbles
Therapeutics
Plasminogen Activators
plasminogen activator
transducers (equipment)
dosage
Transducers
arteries

ASJC Scopus subject areas

  • Agricultural and Biological Sciences(all)
  • Biochemistry, Genetics and Molecular Biology(all)
  • Medicine(all)

Cite this

Diagnostic Ultrasound Induced Inertial Cavitation to Non-Invasively Restore Coronary and Microvascular Flow in Acute Myocardial Infarction. / Xie, Feng; Gao, Shunji; Wu, Juefei; Lof, John; Radio, Stanley; Vignon, Francois; Shi, William; Powers, Jeffry; Unger, Evan C; Everbach, E. Carr; Liu, Jinjin; Porter, Thomas R.

In: PLoS One, Vol. 8, No. 7, e69780, 29.07.2013.

Research output: Contribution to journalArticle

Xie, F, Gao, S, Wu, J, Lof, J, Radio, S, Vignon, F, Shi, W, Powers, J, Unger, EC, Everbach, EC, Liu, J & Porter, TR 2013, 'Diagnostic Ultrasound Induced Inertial Cavitation to Non-Invasively Restore Coronary and Microvascular Flow in Acute Myocardial Infarction', PLoS One, vol. 8, no. 7, e69780. https://doi.org/10.1371/journal.pone.0069780
Xie, Feng ; Gao, Shunji ; Wu, Juefei ; Lof, John ; Radio, Stanley ; Vignon, Francois ; Shi, William ; Powers, Jeffry ; Unger, Evan C ; Everbach, E. Carr ; Liu, Jinjin ; Porter, Thomas R. / Diagnostic Ultrasound Induced Inertial Cavitation to Non-Invasively Restore Coronary and Microvascular Flow in Acute Myocardial Infarction. In: PLoS One. 2013 ; Vol. 8, No. 7.
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AU - Vignon, Francois

AU - Shi, William

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