Abstract Number: PB0023
Meeting: ISTH 2020 Congress
Background: The management of advanced atherosclerotic stenosis reduces the risk of myocardial infarction and its related deaths. The laser atherectomy methods that are currently in use, cause to inflammation and subsequent restenosis.
Aims: The aim of this study was to evaluate the effect of high- dose atorvastatin – loaded microbubbles – mediated sonoporation therapy using B- mode ultrasound- guided focused electrohydraulic shock waves on inflammation and intimal hyperplasia reduction after laser angioplasty in the hamster model of abdominal aorta atherosclerotic severe stenosis, wherein diagnostic B- mode ultrasound is combined with sonoporation therapy system, with a goal of increased safety.
Methods: Briefly, Golden Syrian hamsters were submitted to advanced atherosclerotic severe stenosis by primary intravascular radiofrequency (F= 23.7 MHz, P= 10 W) thermal balloon angioplasty- mediated endothelial injury at the abdominal aorta (approximately 0.5 cm superior to the iliac bifurcation) followed by a 1.5% cholesterol- rich diet injury for 12 weeks. Histopathology results showed the formation of advanced atherosclerosis with lipid and neovessel- rich plaque that resulted to severe stenosis (> 70%) in all of the hamsters´ arteries. Then treatment group underwent ArF excimer laser (193 nm) angioplasty followed by shock wave (V= 15 Kv, F= 2 Hz, Impulses= 50)- mediated sonoporation therapy in combination with simultaneously intravenous high- dose atorvastatin (5 mg/Kg/day)- loaded PESDA (Perfluorocarbon- Exposed Sonicated Dextrose Albumin) microbubbles (100ml/kg, 2-5 ×105 bubbles/ml) administration.
Results: Results from histopathology showed a significant reduction in the mean value for macrophages and smooth muscle cells density in the sonoporation therapy group compared with the other groups (p< 0.05).
Conclusions: Enhanced sonoporation therapy effect of focused shock waves, induced by inertial cavitation effect of microbubbles accompanied by anti- inflammatory, lipophilic and pleiotropic effects of high- dose atorvastatin therapy, can cause to reduce inflammation and intimal hyperplasia after laser angioplasty of atherosclerotic severe stenosis.
To cite this abstract in AMA style:Mehrad H, Foletti A. High-Dose Atorvastatin – Loaded Microbubbles-Mediated Sonoporation Therapy using B – Mode Ultrasound – Guided Focused Electrohydraulic Shock Waves Decreases Inflammation and Restenosis after Laser Angioplasty of Advanced Atherosclerotic Severe Stenosis [abstract]. Res Pract Thromb Haemost. 2020; 4 (Suppl 1). https://abstracts.isth.org/abstract/high-dose-atorvastatin-loaded-microbubbles-mediated-sonoporation-therapy-using-b-mode-ultrasound-guided-focused-electrohydraulic-shock-waves-decreases-inflammation-and-restenosis-after-laser-ang/. Accessed November 30, 2021.
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