{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T02:11:09Z","timestamp":1782439869134,"version":"3.54.5"},"reference-count":30,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2019,7,9]],"date-time":"2019-07-09T00:00:00Z","timestamp":1562630400000},"content-version":"vor","delay-in-days":8,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100001691","name":"Japan Society for the Promotion of Science","doi-asserted-by":"publisher","award":["25462576"],"award-info":[{"award-number":["25462576"]}],"id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ultrasound in Obstet &amp;amp; Gyne"],"published-print":{"date-parts":[[2019,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:p>We describe our experience of high\u2010intensity focused ultrasound (HIFU) for fetal therapy in twin\u2010reversed arterial perfusion (TRAP) sequence. Six pregnant women underwent HIFU therapy, five before 16\u2009weeks and one at 26\u2009weeks. Two types of HIFU system were used: the first\u2010generation system, which comprised a biaxial transducer and continuous exposure pattern, and the second\u2010generation system, which comprised a coaxial transducer and sequential exposure pattern. The first\u2010generation apparatus was used in four cases and the second\u2010generation apparatus was used in two. In three cases, occlusion of the blood vessels mediating flow to the acardiac twin was achieved by HIFU. Two cases experienced intrauterine fetal death despite vessel occlusion. The total survival rate of pump fetuses 2 years after HIFU was 67% and the efficiency rate (the proportion of cases with occlusion or reduced blood flow on ultrasound after HIFU) was 83%. After more than 2 years of follow\u2010up, the surviving infants had no severe clinical complications and no postnatal developmental problems. There was no significant difference in survival rate compared with TRAP cases managed expectantly. Given that complete occlusion of the blood vessels was not achieved in half of the cases, we could not show that HIFU therapy is superior to other treatments. However, HIFU can reduce the cardiac load of the pump fetus and, as it does not require uterine puncture for fetal therapy, there were no fatal complications, such as bleeding, rupture of membranes or infection. Thus, HIFU therapy may represent a less\u2010invasive treatment for TRAP sequence in early pregnancy. Copyright \u00a9 2018 ISUOG. Published by John Wiley &amp; Sons Ltd.<\/jats:p>","DOI":"10.1002\/uog.20101","type":"journal-article","created":{"date-parts":[[2018,8,23]],"date-time":"2018-08-23T05:20:27Z","timestamp":1535001627000},"page":"128-134","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":35,"title":["Treatment of twin\u2010reversed arterial perfusion sequence using high\u2010intensity focused ultrasound"],"prefix":"10.1002","volume":"54","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6242-8510","authenticated-orcid":false,"given":"K.","family":"Seo","sequence":"first","affiliation":[{"name":"Showa University School of Medicine, Department of Obstetrics and Gynecology  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2436-4469","authenticated-orcid":false,"given":"K.","family":"Ichizuka","sequence":"additional","affiliation":[{"name":"Showa University School of Medicine, Department of 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