Abstract Number: PO112
Meeting: ISTH 2021 Congress
Background: Atherosclerosis is the leading cause of cerebrovascular and cardiovascular diseases. The management of advanced atherosclerosis with neovascularization reduces the risk of stroke and myocardial infarction and their related deaths.
Aims: In this study, we developed an experimental low level focused shock wave therapy protocol, and investigated its effectiveness on intraplaque neovessels destruction and advanced atherosclerotic plaque regression, wherein diagnostic B-mode ultrasound is combined with focused-electrohydraulic shock wave generator, with a goal of increased safety.
Methods: Briefly, golden Syrian hamsters underwent primary perivascular severe cold injury at the right common carotid artery followed by a 1.5 % cholesterol-rich diet injury for 12 weeks. Histopathology and ultrasonography results showed the formation of advanced atherosclerosis with neovessel – rich plaque and severe stenosis (> 70%) in all of the hamsters’ arteries. The animals treated by low level focused electrohydraulic shock wave (V= 8 Kv, F= 5 Hz, Impulses= 100) accompanied by HDL- loaded PESDA (Perfluorocarbon- Exposed Sonicated Dextrose Albumin) microbubbles administration and cholesterol diet withdrawal.
Results: Results from histopathology, B-mode and color Doppler ultrasonography showed a significant reduction in the mean value for blood mean velocity, intraplaque neovessels density, wall mean thickness and percentage of luminal cross- sectional area of stenosis and significant increase in the mean value for blood volume flow in the treatment group compared with the other groups (p < 0.05).
Conclusions: Enhanced destruction effect of shock wave- mediated microjets, induced by collapsed microbubbles within the neovessels, concomitant with the enhanced reverse cholesterol transport effect of HDL, induced by sonoporation effect of shock wave and collapsed microbubbles, accompanied by macrophages egress and foam cells efferocytosis effects of cholesterol diet withdrawal and HDL administration, can cause to destroy the intraplaque neovessels, reduce the lesion lipid content and significantly dilate the luminal cross- sectional area of stenosis.
To cite this abstract in AMA style:Mehrad H, Foletti A. Treatment of Advanced Atherosclerotic Plaque with Neovascularization Using B-mode Ultrasound-guided HDL-loaded Microbubbles-mediated Low Level Focused Electrohydraulic Shock Wave Sonoporation Therapy and Cholesterol Diet Withdrawal [abstract]. Res Pract Thromb Haemost. 2021; 5 (Suppl 2). https://abstracts.isth.org/abstract/treatment-of-advanced-atherosclerotic-plaque-with-neovascularization-using-b-mode-ultrasound-guided-hdl-loaded-microbubbles-mediated-low-level-focused-electrohydraulic-shock-wave-sonoporation-therapy/. Accessed August 16, 2022.
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