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B-mode Ultrasound-guided Combined Catheter-based Q-switched-Nd: YAG Laser and Pulsed Low Level Dual Frequency Focused Ultrasound Thrombolytic Therapy Reduce Thrombus Content in the Arterial Atherothrombotic Stenosis

1Islamic Azad University, Basic Sciences Faculty, Department of Physics, Tabriz Branch, Tabriz, Iran, Islamic Republic of, 2Mehrad Research Lab, Division of Translational Development of Noninvasive Treatments, Tabriz, Iran, Islamic Republic of, 3Tabriz University of Medical Sciences, Neurosciences Research Center (NSRC), Tabriz, Iran, Islamic Republic of

Abstract Number: PO103

Meeting: ISTH 2021 Congress

Theme: Arterial Thromboembolism » Cerebrovascular Disorders

Background: A plaque may rupture with high risk of subsequent thrombus mediated acute clinical events such as stroke. The efficacy of intravenous anti-anticoagulant drugs is limited owing to a relatively poor recanalization rate and incomplete function recovery in the majority of treated patients. Therefore, other treatment modalities should be explored.

Aims: The aim of this study was to generate a hamster model of common carotid artery atherothrombotic stenosis and the subsequent investigating the feasibility of combined catheter-based Q-Switched-Nd:YAG laser plus pulsed low level dual frequency focused ultrasound-mediated thrombolytic therapy in this model, wherein diagnostic B-mode ultrasound is combined with thrombolytic therapy system, with a goal of increased safety.

Methods: Briefly, golden Syrian hamsters were submitted to common carotid artery atherothrombotic stenosis by primary balloon injury followed 1.5% cholesterol- rich diet injury for 8 weeks and finally perivascular severe liquid nitrogen-based cold injury. Then treatment group underwent combined B-mode ultrasound-guided Q-switched Nd:YAG laser (λ= 532 nm, P= 10 W, PD= 5 ns) and pulsed low level dual frequency focused ultrasound (F= 750 KHz, I= 10W/cm2, Duty Factor= 20% and F= 1.2 MHz, I= 24W/ cm2, Duty Factor= 50%)- mediated thrombolytic therapy.

Results: Results from histopathology, B-mode and color Doppler ultrasonography, showed a significant reduction in the mean value for thrombus content, percentage of luminal cross-sectional area of stenosis, blood mean velocity and a significant increase in the mean value for blood volume flow at the stenotic region in the treatment group compared with the other groups (P<0.05).

Conclusions: Enhanced anti- thrombotic effect of mechanical inertial cavitation bubbles, induced by combined Q- Switched- Nd:YAG laser and pulsed low level dual frequency focused ultrasound, can cause to reduce the thrombus content and significantly dilate the luminal cross-sectional area of stenosis and lower treatment time.

To cite this abstract in AMA style:

Mehrad H, Farhoudi M. B-mode Ultrasound-guided Combined Catheter-based Q-switched-Nd: YAG Laser and Pulsed Low Level Dual Frequency Focused Ultrasound Thrombolytic Therapy Reduce Thrombus Content in the Arterial Atherothrombotic Stenosis [abstract]. Res Pract Thromb Haemost. 2021; 5 (Suppl 2). https://abstracts.isth.org/abstract/b-mode-ultrasound-guided-combined-catheter-based-q-switched-nd-yag-laser-and-pulsed-low-level-dual-frequency-focused-ultrasound-thrombolytic-therapy-reduce-thrombus-content-in-the-arterial-atherothro/. Accessed August 19, 2022.

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