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The feasibility of ultrasound-assisted endovascular laser thrombolysis in an acute rabbit thrombosis model.

PURPOSE
The current study was aimed to test the feasibility of combined ultrasound and laser technique, namely, ultrasound-assisted endovascular laser thrombolysis (USELT), for thrombolysis by conducting in vivo tests in a rabbit thrombosis model.


METHODS
An acute thrombus was created in the right jugular vein of rabbit and then was treated with ultrasound only, laser only, and USELT to dissolve the blood clot. A total of 20 rabbits were used. Out of which, the first three rabbits were used to titrate the laser and ultrasound parameters. Then, five rabbits were treated with ultrasound only, five rabbits were treated with laser only, and seven rabbits were treated with USELT. During USELT, 532-nm laser pulses were delivered endovascularly directly to the clot through a fiber optic, and 0.5-MHz ultrasound pulses were applied noninvasively to the same region. A laser fluence of 4 to 12 mJ/cm2 and ultrasound amplitude of 1 to 2 MPa were used. Recanalization of the jugular vein was assessed by performing ultrasound doppler imaging immediately after the treatment. The maximum blood flow speed after the treatment as compared to its value before the treatment was used to calculate the blood flow recovery in vessel.


RESULTS
The blood flow was fully recovered (100 %) in three rabbits, partially recovered in two rabbits (more than 50 % and less than 100 %) with mean percentage recovery of 69.73 % and poorly recovered in two rabbits (less than 50%) with mean percentage recovery of 6.2 % in USELT group. On the contrast, the treatment group with ultrasound or laser alone did not show recanalization of vein in any case, all the five rabbits were poorly/not recovered with a mean percentage recovery of 0 %.


CONCLUSIONS
The USELT technology was shown to effectively dissolve the blood clots in an acute rabbit jugular vein thrombosis model.