Abstract Number: PB2208
Meeting: ISTH 2020 Congress
Background: Post thrombotic syndrome is a frequent complication of deep venous thrombosis and is associated with high morbidity and hospitalization. Pulsed cavitational ultrasound therapy (PCUT) emerged recently as a new technique to destroy remotely soft tissue. We demonstrated that PCUT was able to recanalize non-invasively in vitro model of acute venous thrombosis.
Aims: We aim to test the safety and efficacy of venous recanalization by noninvasive PCUT in in vivo swine model of acute venous thrombosis.
Methods: All the experiments were performed on White large X Landrace swine. We induced an acute femoral deep venous thrombosis by using an endovascular approach. A 3 cm length occlusive thrombosis was obtained after 2 hours. Swine were divided in three groups: one with PCUT without follow-up (n=11), one with PCUT and follow-up at 14 days (n=8), and a control group also followed for 14 days (n=8). All swine received curative anticoagulation. To achieve PCUT, a 2.25 MHz transducer centered by a linear probe (SL10-2) was used and cavitation was obtained in the center of the vein. A robotic arm was used to automatically move the transducer along the thrombus. Effectiveness was evaluated by echo-Doppler and phlebography. Safety was assessed by Doppler ultrasound of insonified area and by histological analysis.
Results: Among the 27 swine, we obtained 25 occlusive venous thromboses and 2 partial. The median length of the thrombus was 26 +/- 4,4 mm. Acutely, thrombosis recanalization was systematically obtained among the 19 swine with PCUT with median treatment duration of 33 min. After a 14-day follow-up, 75% of recanalisation remains permeable vs 0% of vein permeable in the no therapy group. No embolism or pulmonary infarction was observed in all pigs.
Conclusions: We have demonstrated in vivo the safety and the efficacy of PCUT for non-invasive venous recanalization, persistent after 2 weeks.
To cite this abstract in AMA style:Khider L, Goudot G, Del Giudice C, Mirault T, Galloula A, Bruneval P, Tanter M, Pernot M, Messas E. Recanalization of Venous Thrombosis by Robotic Assisted High Frequency Pulsed Cavitational Ultrasound Therapy: 2 Weeks Follow-up in a Swine Model [abstract]. Res Pract Thromb Haemost. 2020; 4 (Suppl 1). https://abstracts.isth.org/abstract/recanalization-of-venous-thrombosis-by-robotic-assisted-high-frequency-pulsed-cavitational-ultrasound-therapy-2-weeks-follow-up-in-a-swine-model/. Accessed January 21, 2022.
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