Minimally invasive treatment of intracerebral hemorrhage with magnetic resonance–guided focused ultrasound

2013 ◽  
Vol 118 (5) ◽  
pp. 1035-1045 ◽  
Author(s):  
Stephen J. Monteith ◽  
Sagi Harnof ◽  
Ricky Medel ◽  
Britney Popp ◽  
Max Wintermark ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Minimally Invasive ◽  
Intracerebral Hemorrhage ◽  
Focused Ultrasound ◽  
Safety Data ◽  
Surgical Techniques ◽  
Minimally Invasive Treatment ◽  
Swine Model ◽  
Invasive Treatment

Object Intracerebral hemorrhage (ICH) is a major cause of death and disability throughout the world. Surgical techniques are limited by their invasive nature and the associated disability caused during clot removal. Preliminary data have shown promise for the feasibility of transcranial MR-guided focused ultrasound (MRgFUS) sonothrombolysis in liquefying the clotted blood in ICH and thereby facilitating minimally invasive evacuation of the clot via a twist-drill craniostomy and aspiration tube. Methods and Results In an in vitro model, the following optimum transcranial sonothrombolysis parameters were determined: transducer center frequency 230 kHz, power 3950 W, pulse repetition rate 1 kHz, duty cycle 10%, and sonication duration 30 seconds. Safety studies were performed in swine (n = 20). In a swine model of ICH, MRgFUS sonothrombolysis of 4 ml ICH was performed. Magnetic resonance imaging and histological examination demonstrated complete lysis of the ICH without additional brain injury, blood-brain barrier breakdown, or thermal necrosis due to sonothrombolysis. A novel cadaveric model of ICH was developed with 40-ml clots implanted into fresh cadaveric brains (n = 10). Intracerebral hemorrhages were successfully liquefied (> 95%) with transcranial MRgFUS in a highly accurate fashion, permitting minimally invasive aspiration of the lysate under MRI guidance. Conclusions The feasibility of transcranial MRgFUS sonothrombolysis was demonstrated in in vitro and cadaveric models of ICH. Initial in vivo safety data in a swine model of ICH suggest the process to be safe. Minimally invasive treatment of ICH with MRgFUS warrants evaluation in the setting of a clinical trial.

110 O - Magnetic resonance imaging guided minimally invasive treatment of breast cancer

1996 ◽  
Vol 32 ◽  
pp. S22
Author(s):  
H. Mumtaz ◽  
M.W. Kissin ◽  
M.A. Hall-Craggs ◽  
T. Davidson ◽  
I. Taylor ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Minimally Invasive ◽  
Minimally Invasive Treatment ◽  
Resonance Imaging ◽  
Invasive Treatment

scholarly journals Transcranial MR-guided focused ultrasound sonothrombolysis in the treatment of intracerebral hemorrhage

2013 ◽  
Vol 34 (5) ◽  
pp. E14 ◽  
Author(s):  
Stephen J. Monteith ◽  
Neal F. Kassell ◽  
Oded Goren ◽  
Sagi Harnof
Keyword(s):  
Minimally Invasive ◽  
Intracerebral Hemorrhage ◽  
Focused Ultrasound ◽  
Focal Point ◽  
Disruptive Technology ◽  
Invasive Approach ◽  
Blood Clots ◽  
Volume Blood

Intracerebral hemorrhage remains a significant cause of morbidity and mortality. Current surgical therapies aim to use a minimally invasive approach to remove as much of the clot as possible without causing undue disruption to surrounding neural structures. Transcranial MR-guided focused ultrasound (MRgFUS) surgery is an emerging technology that permits a highly concentrated focal point of ultrasound energy to be deposited to a target deep within the brain without an incision or craniotomy. With appropriate ultrasound parameters it has been shown that MRgFUS can effectively liquefy large-volume blood clots through the human calvaria. In this review the authors discuss the rationale for using MRgFUS to noninvasively liquefy intracerebral hemorrhage (ICH), thereby permitting minimally invasive aspiration of the liquefied clot via a small drainage tube. The mechanism of action of MRgFUS sonothrombolysis; current investigational work with in vitro, in vivo, and cadaveric models of ICH; and the potential clinical application of this disruptive technology for the treatment of ICH are discussed.

R423 – Electrochemical Dissolution of Salivary Calculi

2008 ◽  
Vol 139 (2_suppl) ◽  
pp. P185-P185
Author(s):  
Robert Schatton ◽  
Adam P Stanek ◽  
Afshin Moheb ◽  
Hans Georg Kempf ◽  
Helmut Schatton
Keyword(s):  
Acetic Acid ◽  
Minimally Invasive ◽  
Weight Reduction ◽  
Glass Tube ◽  
Basic Research ◽  
Minimally Invasive Treatment ◽  
Invasive Treatment ◽  
Extracorporeal Shock Wave ◽  
Salivary Calculi

Problem Minimally invasive therapies of sialolithiasis have been developed to avoid complications of sialadenectomy like nerve injury or frey's syndrome. Sialendoscopy and extracorporeal shock wave lithotripsy are used to manage stone removement and fragmentation. The size of salivary calculi often limits minimally invasive treatment. Chemical and electrolytic dissolution have been used successfully to reduce the diameter of sialoliths in vitro. The aim of this study was to compare the effect of electrolitholysis (ELL) and the combination of ELL with chemolitholysis on salivary calculi. Methods Eleven submandibular calculi (7-19mm diameter) were halved. These halves were randomised to the ELL group and the ELL combined with chemolitholysis group. The calculi were placed in a glass tube and two platinum electrodes (0.5mm diameter) were brought in contact with their surfaces. For the ELL group isotonic sodium chloride was used as rinsing solution whereas calculi of the ELL combined with chemolitholysis group were rinsed with diluted acetic acid (0.6%, pH 2.78). Electrical current (30mA, 14V) with periodic current reversal was applied to the electrodes for three hours. To determine the extent of dissolution, the calculi were weighed and photographed before and after the treatment. Results The mean weight reduction of salivary calculi was 14,7±5,8 mg (19,9±8,4%) after ELL and 16,2±8,8 mg (23,1 ±20,5%) after ELL combined with chemolitholysis respectively. The differences were not statistically significant. The corrosive effect of both methods could be shown by morphologic changes of the calculi. Conclusion In this study a comparable weight reduction of salivary calculi was achieved using ELL alone or ELL combined with chemolitholysis with diluted acetic acid. These methods could be helpful to diminish the size of salivary calculi within the scope of minimally invasive treatment of sialolithiasis. Further investigations should be done. Significance Basic research.

scholarly journals THE SELECTION OF PATIENTS FOR MINIMALLY INVASIVE PROCEDURES ON THE THYROID NODULES

2020 ◽  
Vol 23 (2) ◽  
pp. 187-194
Author(s):  
V. G. Saltykova ◽  
Yu. K. Aleksandrov ◽  
Yu. N. Patrunov
Keyword(s):  
Minimally Invasive ◽  
Focused Ultrasound ◽  
Thyroid Nodules ◽  
Size Structure ◽  
High Intensity Focused Ultrasound ◽  
Minimally Invasive Treatment ◽  
Invasive Treatment ◽  
Results Of Treatment ◽  
Selection Of Patients ◽  
Selection Of

Percutaneous laser ablation (PLA), high-intensity focused ultrasound (HIFU), and ultrasound-guided sclerotherapy (PIE) are minimally invasive treatments for benign thyroid nodules (MIT). Methods have different effectiveness depending on the size, structure, and localization of thyroid nodes. When selecting patients for treatment, the technical and biological features of various minimally invasive treatment methods are essential. Out of 124 people with thyroid nodules, 32 patients were selected for minimally invasive treatment. Conducting minimally invasive treatment and evaluating early treatment results in 32 people allowed us to identify the characteristics of thyroid nodes that affect the choice of modes of methods, the technique of their implementation, as well as the likely prognosis of the results of treatment of thyroid nodes (partial regression, complete destruction, the formation of fibrosis). When selecting patients for minimally invasive treatment, the leading method is ultrasound, which allows us to objectively assess risks, prevent possible complications, and predict the dynamics of inflammatory and regenerative processes based on the analysis of the ultrasound pattern.

Minimally Invasive Treatment Options for Managing Spontaneous Intracerebral Hemorrhage

2020 ◽  
Vol 29 (1) ◽  
pp. 5-9 ◽  
Author(s):  
Michael Kim ◽  
Jared Cooper ◽  
Fawaz Al-Mufti ◽  
Chirag Gandhi ◽  
Christian Bowers
Keyword(s):  
Minimally Invasive ◽  
Intracerebral Hemorrhage ◽  
Treatment Options ◽  
Minimally Invasive Treatment ◽  
Spontaneous Intracerebral Hemorrhage ◽  
Invasive Treatment
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