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Percutaneous Transluminal Septal Myocardial Ablation in Hypertrophic Cardiomyopathy
Published in Srilakshmi M. Adhyapak, V. Rao Parachuri, Hypertrophic Cardiomyopathy, 2020
Anene C. Ukaigwe, Paul Sorajja
After this, through a 3 cc syringe, echo contrast is injected through the same OTW balloon under echocardiographic guidance. Any of the commercially available echo contrast agents can be used (e.g., Definity [Perflutren Lipid Microspheres], Lantheus Medical Imaging Billerica, MA; Optison [Perflutren Protein Type A microspheres] General Electric Company, CT; Lumason [sulfur hexafluoride lipid-type A microspheres], Bracco Diagnostics Inc., Monroe Township, NJ). The echo contrast should be diluted with saline to optimize myocardial opacification and minimize attenuation. The echocontrast should be injected slowly. Fast injections causes the echo contrast to fill the left ventricular cavity and may limit visualization. The echocardiogram is assessed to ensure that the target infarct area is the area of maximum flow acceleration in the LVOT in the area of SAM–septal contact. Other areas should be assessed to ensure that the non-target myocardium is not enhanced by echo contrast, especially the RV, papillary muscles, inferior wall, and anterior wall.
PFOB sonosensitive microdroplets: determining their interaction radii with focused ultrasound using MR thermometry and a Gaussian convolution kernel computation
Published in International Journal of Hyperthermia, 2022
Ryan Holman, Laura Gui, Orane Lorton, Pauline Guillemin, Stéphane Desgranges, Christiane Contino-Pépin, Rares Salomir
Ultrasound contrast agents in routine clinical use are gas-filled perfluorocarbon microbubbles with either sulfur hexafluoride, perflutren, or perfluorobutane core and a phospholipid or albumin shell. Applications include echocardiography for left ventricular opacification and endocardial border delineation; along with imaging the liver, breast, and blood perfusion. The four common agents are Optison (GE Healthcare), Sonazoid (GE Healthcare), Sonovue (Bracco Imaging, S.p.A.), and Definity (Lantheus Medical Imaging, Inc.). These microbubbles, also referred to as microspheres, are about 1.2 to 3.1 µm in diameter and are safely administered intravenously at concentrations between 0.65% v:v and 4.4% v:v [17].
Recent advances in targeted delivery of tissue plasminogen activator for enhanced thrombolysis in ischaemic stroke
Published in Journal of Drug Targeting, 2018
Masumeh Zamanlu, Mehdi Farhoudi, Morteza Eskandani, Javad Mahmoudi, Jaleh Barar, Mohammad Rafi, Yadollah Omidi
Gaseous microspheres initially developed as ultrasound contrast agents have been used as thrombolysis enhancing DDSs whose clinical outcomes appear to be promising. In 2008, Alexandrov et al. reported that the tPA-loaded perflutrens (the so-called lipid microspheres) and diagnostic TCD ultrasound were reported to reach and permeate beyond the intracranial occlusions to the tissues with compromised perfusion. The results showed that there were no increases in symptomatic intracranial haemorrhage after systemic thrombolysis in the stroke patients [87]. Therefore, the Transcranial Ultrasound in Clinical Sonothrombolysis (TUCSON) trial was initiated for microspheres dose-escalation and delivery of tPA. The trial results indicated that a dose of 1.4 ml perflutren-lipid microsphere with simultaneous TCD monitoring can be a safe approach that may cause higher early recanalization and clinical recovery rates in comparison with the standard intravenous tPA therapy [82,87]. Meanwhile, if the microspheres are smaller than the red blood cells (RBCs), Doppler ultrasound monitoring can even quantify the plasma flow velocities around acute occlusions as well as the dose of delivered microspheres, which might provide the dose of the delivered drug [88]. However, TUCSON trial was prematurely halted due to the registered safety reasons. Figure 1(C) schematically illustrates tPA-based thrombolytic therapy enhanced by ultrasound and contrast agents in the form of microspheres. It should be noted that when microspheres and liposomes were compared for their potentials of thrombolysis enhancement, in the presence of ultrasound, tPA-loaded ELIP were more effective than the tPA mixed with a contrast agent containing microspheres [89].
Two-dimensional hysterosalpingo-contrast-sonography compared to three/four-dimensional hysterosalpingo-contrast-sonography for the assessment of tubal occlusion in women with infertility/subfertility: a systematic review with meta-analysis
Published in Human Fertility, 2022
Juan Luis Alcázar, Andrea Martinez, Manuel Duarte, Andry Welly, Antonio Marín, Araceli Calle, Raquel Garrido, Maria Angela Pascual, Stefano Guerriero
A total of 30 studies published between January 1992 and April 2019 reporting on 1977 patients and 3885 tubes were included in the final analyses. Twenty-one studies used 2D-HyCoSy to assess tubal occlusion (Ahinko-Hakamaa et al., 2009; Allahbadia, 1993; Allahbadia et al., 1992; Battaglia et al., 1996; Dietrich et al., 1996; Dijkman et al., 2000; Guerriero et al., 1996; Hamed et al., 2009; Hamilton et al., 1998; Hauge et al., 2000; Heikkinen et al., 1995; Inki et al., 1998; Kleinkauf-Houcken et al., 1997; Luciano et al., 2011; Moro et al., 2015; Piccioni et al., 2017; Reis et al., 1998; Strandell et al., 1999; Tanawattanacharoen et al., 2000; Tüfekçi et al., 1992; Van Schoubroeck et al., 2013), six of them used 3D/4D-HyCoSy (Chan et al., 2005; Cheng et al., 2015; Gao et al., 2019; He et al., 2017; W. Wang et al., 2017; Zhou et al., 2012); one study used both techniques but in different set of patients (Kupesic & Plavsic, 2007) and two of them used both techniques in the same patients (Ludwin et al., 2017; Soliman et al., 2015). Regarding contrast agent, four studies used saline solution (Allahbadia, 1993; Allahbadia et al., 1992; Battaglia et al., 1996; Tüfekçi et al., 1992); eleven used a galactose solution (EchovistTM, ScheringAG, Berlin, Germany) (Ahinko-Hakamaa et al., 2009; Chan et al., 2005; Dietrich et al., 1996; Dijkman et al., 2000; Guerriero et al., 1996; Hamilton et al., 1998; Hauge et al., 2000; Kleinkauf-Houcken et al., 1997; Kupesic & Plavsic, 2007; Reis et al., 1998; Strandell et al., 1999; Tanawattanacharoen et al., 2000); six used sterile air-saline solution (Hamed et al., 2009; Heikkinen et al., 1995; Inki et al., 1998; Luciano et al., 2011; Moro et al., 2015; Soliman et al., 2015); five used sulphurhexafluoride (SonoVueTM, Bracco, Milan, Italy) (Cheng et al., 2015; Gao et al., 2019; He et al., 2017; W. Wang et al., 2017; Zhou et al., 2012); two studies used ExEm FoamTM (ExEm; GynaecologIQ, Delft, The Netherlands) (Piccioni et al., 2017; Van Schoubroeck et al., 2013); one study used perflutren lipid microsphere (DefinityTM, Lanthreus Medical Imaging, MA, USA) (Luciano et al., 2011) and one used air-saline and Exem FoamTM (Ludwin et al., 2017).