Author + information
- Received May 5, 2017
- Revision received July 18, 2017
- Accepted July 20, 2017
- Published online December 25, 2017.
- Shelby Kutty, MD, PhD, MHCMa,∗ (, )
- Na Liu, MD, PhDa,b,
- Jia Zhou, MD, PhDa,c,
- Yunbin Xiao, MD, PhDa,
- Juefei Wu, MD, PhDd,
- David A. Danford, MDa,
- John Lof, MSd,
- Feng Xie, MDd and
- Thomas R. Porter, MDd
- aDivision of Pediatric Cardiology, University of Nebraska College of Medicine/Children’s Hospital & Medical Center/Creighton University, Omaha, Nebraska
- bDepartment of Cardiology and Cardiac Catheterization Lab, Second Xiangya Hospital, Central South University, Changsha, China
- cDepartment of Ultrasonography, the First Affiliated Hospital of University of South China, Hengyang, China
- dDepartment of Internal Medicine, Section of Cardiology, University of Nebraska Medical Center, Omaha, Nebraska
- ↵∗Address for correspondence:
Dr. Shelby Kutty, Division of Pediatric Cardiology, University of Nebraska Medical Center, 982265 Nebraska Medical Center, Omaha, Nebraska 68198-2265.
• In a porcine model, we investigated the therapeutic effectiveness of microbubble enhanced sonothrombolysis for treatment of catheter-induced vasospasm and vascular injury, a common complication after femoral arterial catheterization, particularly in children.
• Our results show that microbubble cavitation mediated by brief application of diagnostic high mechanical index impulses is an effective noninvasive method for relieving catheter-induced vasospasm.
• This approach could have potential as an effective treatment for reversal of pulse loss after peripheral arterial injury and vasospasm.
Inertial cavitation inducing ultrasound-mediated microbubble treatments can produce resolution of vasospasm and restoration of distal arterial flow after peripheral artery injury. Resolution of catheter-induced vasospasm is likely to be nitric oxide- mediated because improvements in stenosis diameter and downstream blood flow were blunted following pretreatment with L-NAME. The potential for clinical applicability of this therapy is significant because: 1) microbubbles can be delivered systemically into the site of injury enabling relatively high local concentration; 2) targeted transcutaneous ultrasound delivery is achievable due to the proximity of vessels; and 3) microbubbles and diagnostic ultrasound system used are commercially available.
- catheter-induced vasospasm
- N (ω)-nitro-L-arginine methyl ester
- velocity time integral
Dr. Kutty is supported by the American Heart Association and the National Institute of Child Health and Development. Dr. Porter is supported by the Theodore F Hubbard Foundation. Funding sources were not involved in data collection, data analysis, or manuscript drafting. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose. All institutional and national guidelines for the care and use of laboratory animals were followed and approved by the appropriate institutional committees. Drs. Kutty and Liu contributed equally to this work.
All authors attest they are in compliance with human studies committees and animal welfare regulations of the authors’ institutions and Food and Drug Administration guidelines, including patient consent where appropriate. For more information, visit the JACC: Basic to Translational Science author instructions page.
- Received May 5, 2017.
- Revision received July 18, 2017.
- Accepted July 20, 2017.
- 2017 The Authors