Treatment of Limb Ischemia with Conducted Effects of Catheter-Based Endovascular Ultrasound.

Autor:	Muller MA; Knight Cardiovascular Institute, Oregon Health & Science University, Portland, Oregon, USA., Ozawa K; Knight Cardiovascular Institute, Oregon Health & Science University, Portland, Oregon, USA., Hodovan J; Knight Cardiovascular Institute, Oregon Health & Science University, Portland, Oregon, USA., Hagen MW; Knight Cardiovascular Institute, Oregon Health & Science University, Portland, Oregon, USA., Giraud DSH; Knight Cardiovascular Institute, Oregon Health & Science University, Portland, Oregon, USA., Qi Y; Knight Cardiovascular Institute, Oregon Health & Science University, Portland, Oregon, USA., Xie A; Knight Cardiovascular Institute, Oregon Health & Science University, Portland, Oregon, USA., Hobbs TR; Oregon National Primate Research Center, Oregon Health & Science University, Portland, Oregon., Sheeran PS; Philips Ultrasound, Bothell, Washington, USA., Lindner JR; Knight Cardiovascular Institute, Oregon Health & Science University, Portland, Oregon, USA; Oregon National Primate Research Center, Oregon Health & Science University, Portland, Oregon. Electronic address: lindnerj@ohsu.edu.
Jazyk:	angličtina
Zdroj:	Ultrasound in medicine & biology [Ultrasound Med Biol] 2021 Aug; Vol. 47 (8), pp. 2277-2285. Date of Electronic Publication: 2021 Apr 29.
DOI:	10.1016/j.ultrasmedbio.2021.03.019
Abstrakt:	Ultrasound (US) is known to stimulate endogenous shear-dependent pathways, and can lower microvascular resistance through mediators that are conducted downstream from US exposure. We hypothesized that endovascular US, already in use for thrombolysis in humans, can improve tissue perfusion in the setting of acute limb ischemia through downstream-conducted effects. Models of severe peripheral arterial disease were developed in mice and in rhesus macaques. An endovascular US catheter (2.3 MHz, 0.5-1.1 MPa) was used to expose the limb adductor in mice for 10 min or the femoral artery distal to stenosis in macaques for 15 min. Quantitative contrast-enhanced ultrasound perfusion imaging was performed to assess flow augmentation in the adductor muscle of mice and the calf muscle of macaques. Microvascular blood flow in the ischemic limb relative to the contralateral control limb was reduced to 22 ± 8% in mice and 36 ± 20% in macaques. US produced immediate 2.3- and 3-fold increases (p < 0.05) in the murine and macaque ischemic limbs, respectively. In macaques, perfusion in the ischemic limb was increased to a normal level. We conclude that non-cavitating US produced by endovascular catheters that are used to enhance thrombolysis in humans can reduce vascular resistance and increase limb perfusion in the setting of acute ischemia. Competing Interests: Conflict of interest disclosure Partial research funding and material support in the form of Ekosonic catheters and pulse generators were provided by Boston Scientific. Authorship included an employee of Philips Ultrasound who provided custom pulse sequences for CEU perfusion imaging. (Copyright © 2021 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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