{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T10:52:40Z","timestamp":1784544760144,"version":"3.55.0"},"reference-count":19,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2022,9,29]],"date-time":"2022-09-29T00:00:00Z","timestamp":1664409600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Endovasc Ther"],"published-print":{"date-parts":[[2024,6]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose:<\/jats:title>\n                    <jats:p>Intra-arterial administration of microbubbles (MBs) through an ultrasound (US) catheter increases the local concentration of MBs into the thrombus and may further enhance outcomes of contrast-enhanced sonothrombolysis (CEST). The objective of this study was to evaluate the feasibility and lytic efficacy of intra-arterial infusion of MBs during US-enhanced thrombolysis in both in vitro and in vivo peripheral arterial occluded models.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods:<\/jats:title>\n                    <jats:p>SonoVue and Luminity MBs were infused at a flow rate of 20 mL\/h through either the drug delivery lumen of the US catheter (DDC, n=20) or through the tube lumen of the vascular phantom (systematic infusion, n=20) during thrombolysis with a low-dose urokinase (UK) protocol (50\u2009000 IU\/h) with(out) US application to assess MB survivability and size by pre-treatment and post-treatment measurements. A human thrombus was placed into a vascular phantom of the flow system to examine the lytic effects of CEST by post-treatment D-dimer concentrations measurements of 5 treatment conditions (saline, UK, UK+US, UK+US+SonoVue, and UK+US+Luminity). Thrombolytic efficacy of localized MBs and US delivery was then investigated in vivo in 5 porcine models by arterial blood flow, microcirculation, and postmortem determined thrombus weight and remaining length.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>US exposure significantly decreased SonoVue (p=0.000) and Luminity (p=0.000) survivability by 37% and 62%, respectively. In vitro CEST treatment resulted in higher median D-dimer concentrations for the SonoVue (0.94 [0.07\u20137.59] mg\/mL, p=0.025) and Luminity (0.83 [0.09\u20132.53] mg\/mL, p=0.048) subgroups when compared with thrombolysis alone (0.36 [0.02\u20131.00] mg\/mL). The lytic efficacy of CEST examined in the porcine model showed an improved median arterial blood flow of 21% (7%\u201379%), and a median thrombus weight and length of 1.02 (0.96\u20131.43) g and 2.25 (1.5\u20134.0) cm, respectively. One allergic reaction and 2 arrhythmias were observed due to the known allergic reaction on lipids in the porcine model.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>SonoVue and Luminity can be combined with an US catheter and could potentially accelerate thrombolytic treatment of peripheral arterial occlusions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Impact<\/jats:title>\n                    <jats:p>Catheter-directed thrombolysis showed to be an effective alternative to surgery for acute peripheral arterial occlusions, but this technique is still associated with several limb and life-threatening complications. The effects of thrombolysis on clot dissolution may be further enhanced by intra-arterial administration of microbubbles through an ultrasound catheter. This study demonstrates the feasibility and lytic efficacy of intra-arterial infusion of microbubbles during US-enhanced thrombolysis in both in vitro and in vivo peripheral arterial occluded models.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/15266028221126938","type":"journal-article","created":{"date-parts":[[2022,9,29]],"date-time":"2022-09-29T03:37:57Z","timestamp":1664422677000},"page":"466-473","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":7,"title":["Feasibility of Microbubble-Accelerated Low-Dose Thrombolysis of Peripheral Arterial Occlusions Using an Ultrasound Catheter"],"prefix":"10.1177","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3254-5331","authenticated-orcid":false,"given":"Sabrina A. N.","family":"Doelare","sequence":"first","affiliation":[{"name":"Department of Surgery, Amsterdam Cardiovascular Sciences, Amsterdam UMC \u2013 Vrije Universiteit Amsterdam, Amsterdam, The Netherlands"},{"name":"Department of Physiology, Amsterdam Cardiovascular Sciences, Amsterdam UMC \u2013 Vrije Universiteit Amsterdam, Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johanna H.","family":"Nederhoed","sequence":"additional","affiliation":[{"name":"Department of Surgery, Amsterdam Cardiovascular Sciences, Amsterdam UMC \u2013 Vrije Universiteit Amsterdam, Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Josje M.","family":"Evers","sequence":"additional","affiliation":[{"name":"Department of Surgery, Amsterdam Cardiovascular Sciences, Amsterdam UMC \u2013 Vrije Universiteit Amsterdam, Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebastiaan T.","family":"Roos","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam UMC \u2013 Vrije Universiteit Amsterdam, Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Otto","family":"Kamp","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam UMC \u2013 Vrije Universiteit Amsterdam, Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ren\u00e9 J. P.","family":"Musters","sequence":"additional","affiliation":[{"name":"Department of Physiology, Amsterdam Cardiovascular Sciences, Amsterdam UMC \u2013 Vrije Universiteit Amsterdam, Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Willem","family":"Wisselink","sequence":"additional","affiliation":[{"name":"Department of Surgery, Amsterdam Cardiovascular Sciences, Amsterdam UMC \u2013 Vrije Universiteit Amsterdam, Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0129-1607","authenticated-orcid":false,"given":"Vincent","family":"Jongkind","sequence":"additional","affiliation":[{"name":"Department of Surgery, Amsterdam Cardiovascular Sciences, Amsterdam UMC \u2013 Vrije Universiteit Amsterdam, Amsterdam, The Netherlands"},{"name":"Department of Surgery, Dijklander Hospital, Hoorn, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harm P.","family":"Ebben","sequence":"additional","affiliation":[{"name":"Department of Surgery, Amsterdam Cardiovascular Sciences, Amsterdam UMC \u2013 Vrije Universiteit Amsterdam, Amsterdam, The Netherlands"},{"name":"Department of Physiology, Amsterdam Cardiovascular Sciences, Amsterdam UMC \u2013 Vrije Universiteit Amsterdam, Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8455-286X","authenticated-orcid":false,"given":"Kak K.","family":"Yeung","sequence":"additional","affiliation":[{"name":"Department of Surgery, Amsterdam Cardiovascular Sciences, Amsterdam UMC \u2013 Vrije Universiteit Amsterdam, Amsterdam, The Netherlands"},{"name":"Department of Physiology, Amsterdam Cardiovascular Sciences, Amsterdam UMC \u2013 Vrije Universiteit Amsterdam, Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2022,9,29]]},"reference":[{"key":"bibr1-15266028221126938","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMcp1006054"},{"key":"bibr2-15266028221126938","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2010.01.080"},{"key":"bibr3-15266028221126938","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejvs.2014.06.042"},{"key":"bibr4-15266028221126938","doi-asserted-by":"publisher","DOI":"10.1177\/152660280701400402"},{"key":"bibr5-15266028221126938","doi-asserted-by":"publisher","DOI":"10.1177\/152660280701400218"},{"key":"bibr6-15266028221126938","volume-title":"Presented at the 35th annual VEITH symposium","author":"Kasirajan 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