Premium
Non‐invasive recanalization of deep venous thrombosis by high frequency ultrasound in a swine model with follow‐up
Author(s) -
Goudot Guillaume,
Khider Lina,
Del Giudice Costantino,
Mirault Tristan,
Galloula Alexandre,
Bruneval Patrick,
Julia Pierre,
Sapoval Marc,
Houdouin Alexandre,
Tanter Mickaël,
Suarez Daniel,
Rémond Mathieu,
Messas Emmanuel,
Pernot Mathieu
Publication year - 2020
Publication title -
journal of thrombosis and haemostasis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.947
H-Index - 178
eISSN - 1538-7836
pISSN - 1538-7933
DOI - 10.1111/jth.15034
Subject(s) - medicine , thrombus , venous thrombosis , pulmonary embolism , ultrasound , thrombosis , femoral vein , deep vein , therapeutic ultrasound , surgery , radiology
Aims Pulsed cavitational ultrasound therapy (thombotripsy) allows the accurate fractionation of a distant thrombus. We aimed to evaluate the efficacy and safety of non‐invasive thrombotripsy using a robotic assisted and high frequency ultrasound approach to recanalize proximal deep venous thrombosis (DVT) in a swine model. Methods Occlusive thrombosis was obtained with a dual jugular and femoral endoveinous approach. The therapeutic device was composed of a 2.25 MHz focused transducer centered by a linear ultrasound probe, and a robotic arm. The feasibility, security, and efficacy (venous channel patency) assessment after thrombotripsy was performed on 13 pigs with acute occluded DVT. To assess the mid‐term efficacy of this technique, 8 pigs were followed up for 14 days after thrombotripsy and compared with 8 control pigs. The primary efficacy endpoint was the venous patency. Safety was assessed by the search for local vessel wall injury and pulmonary embolism. Results We succeeded in treating all pigs except two with no accessible femoral vein. After median treatment duration of 23 minutes of cavitation, all treated DVT were fully recanalized acutely. At 14 days, in the treated group, six of the eight pigs had a persistent patent vein and two pigs had a venous reocclusion. In the control group all pigs had a persistent venous occlusion. At sacrifice, no local vein nor arterial wall damage were observed as well as no evidence of pulmonary embolism in all pigs. Conclusion High frequency thrombotripsy seems to be effective and safe for non‐invasive venous recanalization of DVT.