Hepatic and Renal Histotripsy in an Anticoagulated Porcine Model.

Autor:	Mauch SC; Department of Radiology, University of Wisconsin, Madison, Wisconsin., Zlevor AM; Department of Radiology, University of Wisconsin, Madison, Wisconsin., Knott EA; Department of Radiology, University of Wisconsin, Madison, Wisconsin., Couillard AB; Department of Radiology, University of Wisconsin, Madison, Wisconsin., Periyasamy S; Department of Radiology, University of Wisconsin, Madison, Wisconsin., Williams EC; Department of Medicine, University of Wisconsin, Madison, Wisconsin., Swietlik JF; Department of Radiology, University of Wisconsin, Madison, Wisconsin., Laeseke PF; Department of Radiology, University of Wisconsin, Madison, Wisconsin., Zhang X; Department of Pathology, University of Wisconsin, Madison, Wisconsin., Xu Z; Department of Biomedical Engineering, University of Michigan, Ann Arbor, Michigan., Abel EJ; Department of Radiology, University of Wisconsin, Madison, Wisconsin; Department of Urology, University of Wisconsin, Madison, Wisconsin., Lee FT Jr; Department of Radiology, University of Wisconsin, Madison, Wisconsin; Department of Urology, University of Wisconsin, Madison, Wisconsin; Department of Biomedical Engineering, University of Wisconsin, Madison, Wisconsin., Ziemlewicz TJ; Department of Radiology, University of Wisconsin, Madison, Wisconsin. Electronic address: tziemlewicz@uwhealth.org.
Jazyk:	angličtina
Zdroj:	Journal of vascular and interventional radiology : JVIR [J Vasc Interv Radiol] 2023 Mar; Vol. 34 (3), pp. 386-394.e2. Date of Electronic Publication: 2022 Dec 09.
DOI:	10.1016/j.jvir.2022.11.034
Abstrakt:	Purpose: To determine the risk of mechanical vessel wall damage resulting in hemorrhage during and after hepatic and renal histotripsy in an anticoagulated in vivo porcine model. Materials and Methods: Non-tumor-bearing pigs (n = 8; mean weight, 52.5 kg) were anticoagulated with warfarin (initial dose, 0.08 mg/kg) to a target prothrombin time (PT) of 30%-50% above baseline. A total of 15 histotripsy procedures were performed (kidney: n = 8, 2.0-cm sphere; liver: n = 7, 2.5-cm sphere). Treatments were immediately followed by computed tomography (CT) imaging. Animals were observed for 7 days while continuing anticoagulation, followed by repeat CT and necropsy. Results: All animals survived to complete the entire protocol with no signs of disability or distress. Three animals had hematuria (pink urine without clots). Baseline PT values (mean, 16.0 seconds) were elevated to 22.0 seconds (37.5% above baseline, P = .003) on the day of treatment and to 28.8 seconds (77.8% above baseline, P < .001) on the day of necropsy. At the time of treatment, 5 of 8 (63%) animals were at a therapeutic anticoagulation level, and all 8 animals (100%) reached therapeutic levels by the time of necropsy. There were no cases of intraparenchymal, peritoneal, or retroperitoneal hemorrhage associated with any treatments despite 5 of 7 (71%) liver and all 8 (100%) kidney treatments extending to the organ surface. Conclusions: Liver and kidney histotripsy seems safe with no elevated bleeding risk in this anticoagulated animal model, supporting the possibility of histotripsy treatments in patients on anticoagulation. (Copyright © 2022 SIR. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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