TY - JOUR
AU1 - ROSENSCHEIN, URI
AB - The clinical management of intracoronary thrombosis presents a therapeutic challenge. A variety of pharmaceutical agents have been investigated as an adjunct to balloon angioplasty and stenting with no conclusive evidence to which is the best therapeutic strategy. Our group has investigated the use of therapeutic ultrasound in interventional cardiology over the last few years. Ultrasonic energy (41 KHz) is transmitted from a transducer as longitudinal vibrations of a 140‐cm long solid probe, which directs the energy into the arterial system. In the ACUTE study, consecutive patients with first infarct, only acute anterior myocardial infarction, and occluded LAD were studied. Final flow of TIMI grade 3 was achieved in 93% of the patients. During the procedure, there were no clinical or angiographic adverse events. At 6‐month follow‐up, a significant improvement of left ventricular ejection fraction was observed. There was a low clinical event rate. The Acolysis Registry followed the ACUTE trial. The purpose of this registry was to investigate coronary ultrasound thrombolysis in the different clinical settings of intracoronary thrombosis. Preliminary data (n = 51), show that 56% of the patients were treated for acute myocardial infarction, 25% for unstable angina, and 19% for diseased saphenous vein grafts (SVG). Ninety percent of the vessels were occluded (TIMI 0‐1 flow) at baseline, median age clot was 4 days. Device and procedural success was obtained in 84% and 82%, respectively. Intriguing data came from the SVG subset of patients. Angiographic analysis revealed that 75% of the SVGs were occluded prior to the procedure. Sonication led to successful recanalization in 70% of the patients. In summary, this data suggests that therapeutic ultrasound is effective and safe for inducing intracoronary thrombolysis. Ultrasound can be used to treat thrombi that are a few hours to a few weeks old. Lysis of intracoronary thrombus by ultrasound is a safe and effective procedure. Furthermore, ultrasound thrombolysis is a viable alternative to the pharmacological approach. Local application of ultrasound achieves a high success rate with minimal local or systemic adverse events.
TI - Ultrasound Thrombolysis : An Alternative to the Pharmacological Approach
JF - Journal of Interventional Cardiology
DO - 10.1111/j.1540-8183.1998.tb00174.x
DA - 1998-12-01
UR - https://www.deepdyve.com/lp/wiley/ultrasound-thrombolysis-an-alternative-to-the-pharmacological-approach-8YkhHqLbAl
SP - 603
VL - 11
IS - 6
DP - DeepDyve
ER -