An Investigation of High Intensity Focused Ultrasound Thrombolysis

Investigations into high intensity focused ultrasound (HIFU) thrombolysis in vitro and in vivo in a rabbit femoral artery thrombus model were performed. A 1.51 MHz focused transducer was used to treat clots with pulse lengths of 1-10 ms, acoustic powers of 1-300 W and exposure durations of 5-20 s. Our measurements indicate the creation of acoustic radiation force induced clot displacements are insufficient to mechanically fractionate clots, despite reaching displacements >100 μm. Only under the presence of inertial cavitation was HIFU able to disrupt clots. Cavitation thresholds of 160 W in vitro and 215 W in vivo were observed. In vitro, clots insonified at powers above the cavitation threshold eroded regions up to 2.5x the transducer beam width. Successful recanalization in vivo occurred in 5/20 cases for 1ms pulses at powers >215 W. 10 ms pulses created high incidences of symptomatic bleeding while 1 ms pulses did not. These results demonstrate treatment feasibility in vivo, although further work is required to understand the influence of different acoustic parameters on treatment outcome.