Effekt of blood flow shutdown on the vein damage when exposed to HIFU

2017 ◽  
pp. 46-50
Author(s):  
Н.Н. Петрищев ◽  
Д.Ю. Семенов ◽  
А.Ю. Цибин ◽  
Г.Ю. Юкина ◽  
А.Е. Беркович ◽  
...  
Keyword(s):  
Blood Flow ◽  
Structural Changes ◽  
Focused Ultrasound ◽  
Vena Cava ◽  
Posterior Wall ◽  
High Intensity Focused Ultrasound ◽  
Vein Wall ◽  
Ultrasound Exposure ◽  
Isolated Segment ◽  
The Impact

The purpose. In the study we investigated the impact of the partial blood flow shutdown on structural changes in the rabbit vena cava posterior wall after exposure to high-intensity focused ultrasound (HIFU). Methods. Ultrasound Exposure: frequency of 1.65 MHz, the ultrasound intensity in the focus of 13.6 kW/cm, the area of the focal spot 1 mm, continuous ultrasound, exposure for 3 seconds. Results. Immediately after HIFU exposure all layers of the vein wall showed characteristic signs of thermal damage. A week after exposure structural changes in the intima, media and adventitia was minimal in the part of vessel with preserved blood flow, and after 4 weeks the changes were not revealed. A week after HIFU exposure partial endothelium destruction, destruction of myocytes, disorganization and consolidation of collagen fibers of the adventitia were observed in an isolated segment of the vessel, and in 4 weeks endothelium restored and signs of damage in media and adventitia persisted, but were less obvious than in a week after exposure. Conclusion. The shutdown of blood flow after exposure to HIFU promotes persistent changes in the vein wall. Vein compression appears to be necessary for the obliteration of the vessel, when using HIFU-technology.

scholarly journals Time-Restricted Salutary Effects of Blood Flow Restoration on Venous Thrombosis and Vein Wall Injury in Mouse and Human Subjects

Circulation ◽  
2021 ◽  
Author(s):  
Wenzhu Li ◽  
Chase W. Kessinger ◽  
Makoto Orii ◽  
Hang Lee ◽  
Lang Wang ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Blood Flow ◽  
Venous Thrombosis ◽  
Vena Cava ◽  
Therapeutic Window ◽  
Vein Wall ◽  
Specific Symptom ◽  
Catheter Directed Thrombolysis ◽  
The Impact

Background: Up to 50% of patients with proximal deep venous thrombosis (DVT) will develop the post-thrombotic syndrome (PTS) characterized by limb swelling and discomfort, hyperpigmentation, skin ulcers, and impaired quality-of-life. While catheter-based interventions enabling restoration of blood flow (RBF) have demonstrated little benefit on PTS, the impact on the acuity of the thrombus and mechanisms underlying this finding remain obscure. Here in experimental and clinical studies, we examined whether RBF has a restricted time window for improving DVT resolution. Methods: First, experimental stasis DVT was generated in C57/BL6 mice (N=291) by inferior vena cava ligation. To promote RBF, mice underwent mechanical de-ligation with or without intravenous recombinant tissue plasminogen activator (rtPA), administered two days after de-ligation. RBF was assessed over time by ultrasonography and intravital microscopy. Resected thrombosed IVC specimens underwent thrombus and vein wall histological and gene expression assays. Next, in a clinical study, we conducted a post-hoc analysis of the ATTRACT pharmacomechanical catheter-directed thrombolysis (PCDT) trial (NCT00790335) to assess the effects of PCDT on VEINES quality-of-life (VEINES-QoL) and Villalta scores for specific symptom-onset-to-randomization (SOR) timeframes. Results: Mice that developed RBF by day 4, but not later, exhibited reduced day 8 thrombus burden parameters and reduced day 8 vein wall fibrosis and inflammation, compared to controls. In mice without RBF, rtPA administered at day 4, but not later, reduced day 8 thrombus burden and vein wall fibrosis. Notably, in mice already exhibiting RBF by day 4, rtPA administration did not further reduce thrombus burden or vein wall fibrosis. In the ATTRACT trial, patients receiving PCDT in an intermediate SOR timeframe of 4-8 days demonstrated maximal benefits in VEINES-QoL and Villalta scores (between group difference=8.41 and 1.68 respectively, p<0.001 vs. patients not receiving PCDT). PCDT did not improve PTS scores for patients having an SOR time of <4 days or >8 days. Conclusions: Taken together, these data illustrate that within a restricted therapeutic window, RBF improves DVT resolution, and PCDT may improve clinical outcomes. Further studies are warranted to examine the value of time-restricted RBF strategies to reduce PTS in DVT patients.

Current and Future Surgical and Interventional Management Options for Adenomyosis

2020 ◽  
Vol 38 (02/03) ◽  
pp. 157-167
Author(s):  
Joseph Chen ◽  
Anne E. Porter ◽  
Kimberly A. Kho
Keyword(s):  
Focused Ultrasound ◽  
Wedge Resection ◽  
Abnormal Uterine Bleeding ◽  
High Intensity Focused Ultrasound ◽  
Future Research ◽  
Obstetric Outcomes ◽  
Management Options ◽  
Recommended Treatment ◽  
The Impact

AbstractHistorically, hysterectomy has been the recommended treatment for patients with adenomyosis. However, in the past two decades, various uterine-sparing treatment methods have emerged. These range from excisional techniques such as adenomyomectomy or wedge resection to uterine artery embolization, radiofrequency thermal ablation, hysteroscopic excision, endometrial ablation, and high-intensity focused ultrasound. While largely investigative for the treatment of adenomyosis, these procedures have demonstrated improvement in symptoms including abnormal uterine bleeding, dysmenorrhea, pelvic pain, and overall quality of life. However, long-term data including fertility and obstetric outcomes are needed. Future research is needed to better understand the impact of these uterine-preserving techniques to expand our armamentarium for the treatment of adenomyosis.

scholarly journals The electrolytic inferior vena cava model (EIM) to study thrombogenesis and thrombus resolution with continuous blood flow in the mouse

2013 ◽  
Vol 109 (06) ◽  
pp. 1158-1169 ◽  
Author(s):  
Christine M. Alvarado ◽  
Shirley K. Wrobleski ◽  
Dallas W. Slack ◽  
Angela E. Hawley ◽  
Diana M. Farris ◽  
...  
Keyword(s):  
Blood Flow ◽  
Inferior Vena Cava ◽  
Inferior Vena ◽  
Copper Wire ◽  
Vena Cava ◽  
Electrical Current ◽  
Strong Positive Correlation ◽  
Vein Wall ◽  
Time Points ◽  
Ivc Thrombus

SummaryPreviously, we presented the electrolytic inferior vena cava (IVC) model (EIM) during acute venous thrombosis (VT). Here, we present our evaluation of the EIM for chronic VT time points in order to determine whether this model allows for the study of thrombus resolution. C57BL/6 mice (n=191) were utilised. In this model a copper-wire, inserted into a 25-gauge needle, is placed in the distal IVC and another subcutaneously. An electrical current (250 Amp/15 minutes) activates the endothelial cells, inducing thrombogenesis. Ultrasound, thrombus weight (TW), vein wall leukocyte counts, vein wall thickness/ fibrosis scoring, thrombus area and soluble P-selectin (sP-sel) were performed at baseline, days 1, 2, 4, 6, 9, 11 and 14, post EIM. A correlation between TW and sP-sel was also determined. A thrombus formed in each mouse undergoing EIM. Blood flow was documented by ultrasound at all time points. IVC thrombus size increased up to day 2 and then decreased over time, as shown by ultrasound, TW, and sP-sel levels. TW and sP-sel showed a strong positive correlation (r=0.48, p<0.0002). Vein wall neutrophils were the most common cell type present in acute VT (up to day 2) with monocytes becoming the most prevalent in chronic VT (from day 6 to day 14). Thrombus resolution was demonstrated by ultrasound, TW and thrombus area. In conclusion, the EIM produces a non-occlusive and consistent IVC thrombus, in the presence of constant blood flow, allowing for the study of VT at both acute and chronic time points. Thrombus resolution was demonstrated by all modalities utilised in this study.Note: Results were presented, in part, at the 24th American Venous Forum Annual Meeting 2012 in Orlando, FL, USA.

scholarly journals Novel Therapeutic Method for Unresectable Pancreatic Cancer-The Impact of the Long-Term Research in Therapeutic Effect of High-Intensity Focused Ultrasound (HIFU) Therapy

2021 ◽  
Vol 28 (6) ◽  
pp. 4845-4861
Author(s):  
Atsushi Sofuni ◽  
Yasutsugu Asai ◽  
Takayoshi Tsuchiya ◽  
Kentaro Ishii ◽  
Reina Tanaka ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
High Intensity ◽  
Focused Ultrasound ◽  
Symptom Relief ◽  
Tumor Ablation ◽  
High Intensity Focused Ultrasound ◽  
Therapeutic Effects ◽  
Unresectable Pancreatic Cancer ◽  
Advanced Therapy ◽  
The Impact

High-intensity focused ultrasound (HIFU) is a novel advanced therapy for unresectable pancreatic cancer (PC). HIFU therapy with chemotherapy is being promoted as a novel method to control local advancement by tumor ablation. We evaluated the therapeutic effects of HIFU therapy in locally advanced and metastatic PC. PC patients were treated with HIFU as an optional local therapy and systemic chemotherapy. The FEP-BY02 (Yuande Bio-Medical Engineering) HIFU device was used under ultrasound guidance. Of 176 PC patients, 89 cases were Stage III and 87 were Stage IV. The rate of complete tumor ablation was 90.3%, while that of symptom relief was 63.8%. The effectiveness on the primary lesions were as follows: complete response (CR): n = 0, partial response (PR): n = 21, stable disease (SD): n = 105, and progressive disease (PD): n = 47; the primary disease control rate was 71.0%. Eight patients underwent surgery. The median survival time (MST) after diagnosis for HIFU with chemotherapy compared to chemotherapy alone (100 patients in our hospital) was 772.3 vs. 346.6 days (p < 0.001). Compared with chemotherapy alone, the combination of HIFU therapy and chemotherapy demonstrated significant prolongation of prognosis. This study suggests that HIFU therapy has the potential to be a novel combination therapy for unresectable PC.

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