Efficacy of ultrasound assisted catheter-directed thrombolysis compared to catheter-directed thrombolysis in vitro. (January 2023)

• Record Type: Journal Article
• Authors: Nadjiri, Jonathan; Kierse, Anna; Sendlbeck, Melanie; Janssen, Agnes; Geith, Tobias; Waggershauser, Tobias; Paprottka, Philipp M
• Is Part Of: Acta radiologica. Volume 64:Number 1(2023)
• Page Start: 119
• Page End: 124
• Publication Date: 2023-01
• Subjects: Ultrasound assisted catheter-directed thrombolysis -- lysis -- thrombolysis -- thrombus -- efficacy; Radiology, Medical -- Periodicals; Radiography, Medical -- Periodicals; Radiotherapy -- Periodicals; 616.0757
• DOI: 10.1177/02841851211061440
• Languages: English
• ISSNs: 0284-1851

Abstract

Background: Catheter-directed thrombolysis (CDT) is an effective and safe endovascular method used in critical limb ischemia and many other thromboembolic events. Ultrasound-assisted catheter-directed thrombolysis (US-CDT) is an emerging technique considered to accelerate thrombolysis and therefore is supposed to improve outcome. Purpose: To evaluate the efficacy of US-CDT in comparison to standard CDT in vitro. Material and Methods: A total of 69 sets of human venous blood were evaluated, each comprising a tube just treated with CDT, a tube treated with US-CDT, and a control tube. All tubes were kept under physiological conditions. Except for the controls, in all tubes 5 mg of tissue-type plasminogen activator was administered over the predetermined treatment interval. Thrombus mass was weighted at the end of the lysis intervals at 6 h or 24 h, respectively. Results: CDT led to a mean thrombus reduction of 32% and ultrasound-assisted lysis led to a mean thrombus reduction of 41% ( P < 0.001 for both). Thrombus reduction was significantly higher after US-CDT compared to CDT ( P = 0.001). The better efficacy of US-CDT was mostly already apparent at early phases during thrombolysis and did further mildly increase over time (r = 0.24; P = 0.047). Conclusion: In vitro US-CDT is significantly superior to standard CDT; this effect is apparent at an early timepoint of lysis and slightly further increases over time.