Intra-clot Microbubble-Enhanced Ultrasound Accelerates Catheter-Directed Thrombolysis for Deep Vein Thrombosis: A Clinical Study

Abstract

Insufficiency of microbubbles in the vessel-obstructing thrombus significantly reduces the effectiveness of ultrasound thrombolysis. With catheter-directed thrombolysis (CDT), microbubbles can be delivered directly into the thrombus. In this study, we combined CDT with intra-clot microbubble-enhanced ultrasound thrombolysis (IMUT) to investigate its safety and efficiency in thrombolysis in patients with acute lower limb deep vein thrombosis (DVT). For IMUT, a 1-MHz air-backed transducer directed 100-μs-pulse-length and 100-Hz-pulse-repetition pressure at 1 MPa was used. Thirteen DVT patients in the study group were treated with CDT and IMUT. Forty-three DVT patients in the historical control group were treated with CDT alone. The results indicated that the average thrombolysis time of the study group was significantly shorter (5.23 ± 1.59 d) than that of the control (10.00 ± 2.69 d), and the overall urokinase dosage of the study group ([3.82 ± 1.68] × 10⁶ IU) was lower than that of the control ([4.99 ± 2.26] × 10⁶ IU). No procedure-related complications were noted in either group. Therefore, combining CDT with IMUT can improve thrombolysis safely and efficiently.

Keywords: Catheter-directed thrombolysis; Deep vein thrombosis; Microbubble; Ultrasound.