BACKGROUND: Intracerebral hemorrhage (ICH) is characterized by a 30-d mortality rate of 40% and significant disability for those who survive. OBJECTIVE: To investigate the initial safety concerns of histotripsy mediated clot liquefaction and aspiration in a porcine ICH model. Histotripsy is a noninvasive, focused ultrasound technique that generates cavitation to mechanically fractionate tissue. Histotripsy has the potential to liquefy clot in the brain and facilitate minimally invasive aspiration. METHODS: About 1.75-mL clots were formed in the frontal lobe of the brain (n = 18; n = 6/group). The centers of the clots were liquefied with histotripsy 48 h after formation, and the content was either evacuated or left within the brain. A control group was left untreated. Pigs underwent magnetic resonance imaging (MRI) 7 to 8 d after clot formation and were subsequently euthanized. Neurological behavior was assessed throughout. Histological analysis was performed on harvested brains. A subset of pigs underwent acute analysis (≤6 h). RESULTS: Histotripsy was able to liquefy the center of clots without direct damage to the perihematomal brain tissue. An average volume of 0.9 ± 0.5 mL was drained after histotripsy treatment. All groups showed mild ischemia and gliosis in the perihematomal region; however, there were no deaths or signs of neurological dysfunction in any groups. CONCLUSION: This study presents the first analysis of histotripsy-based liquefaction of ICH in vivo. Histotripsy safely liquefies clots without significant additional damage to the perihematomal region. The liquefied content of the clot can be easily evacuated, and the undrained clot has no effect on pig survival or neurological behavior.
BACKGROUND:Intracerebral hemorrhage (ICH) is characterized by a 30-d mortality rate of 40% and significant disability for those who survive. OBJECTIVE: To investigate the initial safety concerns of histotripsy mediated clot liquefaction and aspiration in a porcine ICH model. Histotripsy is a noninvasive, focused ultrasound technique that generates cavitation to mechanically fractionate tissue. Histotripsy has the potential to liquefy clot in the brain and facilitate minimally invasive aspiration. METHODS: About 1.75-mL clots were formed in the frontal lobe of the brain (n = 18; n = 6/group). The centers of the clots were liquefied with histotripsy 48 h after formation, and the content was either evacuated or left within the brain. A control group was left untreated. Pigs underwent magnetic resonance imaging (MRI) 7 to 8 d after clot formation and were subsequently euthanized. Neurological behavior was assessed throughout. Histological analysis was performed on harvested brains. A subset of pigs underwent acute analysis (≤6 h). RESULTS: Histotripsy was able to liquefy the center of clots without direct damage to the perihematomal brain tissue. An average volume of 0.9 ± 0.5 mL was drained after histotripsy treatment. All groups showed mild ischemia and gliosis in the perihematomal region; however, there were no deaths or signs of neurological dysfunction in any groups. CONCLUSION: This study presents the first analysis of histotripsy-based liquefaction of ICH in vivo. Histotripsy safely liquefies clots without significant additional damage to the perihematomal region. The liquefied content of the clot can be easily evacuated, and the undrained clot has no effect on pig survival or neurological behavior.
Authors: M L Flaherty; M Haverbusch; P Sekar; B Kissela; D Kleindorfer; C J Moomaw; L Sauerbeck; A Schneider; J P Broderick; D Woo Journal: Neurology Date: 2006-04-25 Impact factor: 9.910
Authors: Zhen Xu; Achiau Ludomirsky; Lucy Y Eun; Timothy L Hall; Binh C Tran; J Brian Fowlkes; Charles A Cain Journal: IEEE Trans Ultrason Ferroelectr Freq Control Date: 2004-06 Impact factor: 2.725
Authors: Tyler Gerhardson; Jonathan R Sukovich; Aditya S Pandey; Timothy L Hall; Charles A Cain; Zhen Xu Journal: Ultrasound Med Biol Date: 2017-07-14 Impact factor: 2.998
Authors: William W Roberts; Timothy L Hall; Kimberly Ives; J Stuart Wolf; J Brian Fowlkes; Charles A Cain Journal: J Urol Date: 2006-02 Impact factor: 7.450
Authors: Kuang-Wei Lin; Yohan Kim; Adam D Maxwell; Tzu-Yin Wang; Timothy L Hall; Zhen Xu; J Brian Fowlkes; Charles A Cain Journal: IEEE Trans Ultrason Ferroelectr Freq Control Date: 2014-02 Impact factor: 2.725
Authors: K R Wagner; G Xi; Y Hua; M Kleinholz; G M de Courten-Myers; R E Myers; J P Broderick; T G Brott Journal: Stroke Date: 1996-03 Impact factor: 7.914
Authors: Tatiana D Khokhlova; John C Kucewicz; Ekaterina M Ponomarchuk; Christopher Hunter; Matthew Bruce; Vera A Khokhlova; Thomas J Matula; Wayne Monsky Journal: Ultrasound Med Biol Date: 2020-05-20 Impact factor: 2.998
Authors: Hongchae Baek; Daniel Lockwood; Emily Jo Mason; Emmanuel Obusez; Matthew Poturalski; Richard Rammo; Sean J Nagel; Stephen E Jones Journal: Front Neurol Date: 2022-05-09 Impact factor: 4.086
Authors: Zhongtao Hu; Lu Xu; Chih-Yen Chien; Yaoheng Yang; Yan Gong; Dezhuang Ye; Christopher Pham Pacia; Hong Chen Journal: IEEE Trans Ultrason Ferroelectr Freq Control Date: 2021-10-22 Impact factor: 2.725
Authors: Marc Melià-Sorolla; Carlos Castaño; Núria DeGregorio-Rocasolano; Luis Rodríguez-Esparragoza; Antoni Dávalos; Octavi Martí-Sistac; Teresa Gasull Journal: Int J Mol Sci Date: 2020-09-08 Impact factor: 5.923