alexa Noninvasive Transcranial Clot Lysis Using High Intensit
ISSN: 2155-9562

Journal of Neurology & Neurophysiology
Open Access

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Research Article

Noninvasive Transcranial Clot Lysis Using High Intensity Focused Ultrasound

T Hölscher1,2*, DJ Fisher1, R Raman2,3, K Ernstrom3, E Zadicario4, WG Bradley1 and A Voie1

1Department of Radiology, University of California, San Diego, USA

2Department of Neurosciences, University of California, San Diego, USA

3Department of Familyand Preventive Medicine, University of California, San Diego, USA

4InSightec, Inc., Tirat Carmel, Israel

Corresponding Author:
Dr. Thilo Hoelscher, Associate Professor
Departments of Radiology and Neurosciences
University of California, San Diego, 200 West Arbor Drive
San Diego, CA 92103-8756
Tel: +1-619-543-5251
Fax: +1-619-543-6372
E-mail: [email protected]

Received date: November 08, 2012; Accepted date: December 17, 2012; Published date: December 19, 2012

Citation: Hölscher T, Fisher DJ, Raman R, Ernstrom K, Zadicario E, et al. (2011) Noninvasive Transcranial Clot Lysis Using High Intensity Focused Ultrasound. J Neurol Neurophysiol S1. doi:10.4172/2155-9562.S1-002

Copyright: © 2011 Hölscher T, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.



Background: Initial data using transcranial ultrasound in combination with tissue Plasminogen Activator (tPA) for sonothrombolysis in stroke are promising. However, absorption and defocusing of the ultrasound beam occur during transskull insonation, limiting the efficiency of this approach to high extent. The purpose of this in vitro study was to investigate whether transcranial sonothrombolysis can be achieved using High Intensity Focused Ultrasound (HIFU) without the use of tPA. Methods and Results: Transskull clot lysis (N=420) using a novel HIFU head system was performed using an in vitro flow model. Experiments were performed using varying acoustic output powers, changing flow conditions, and different cadaveric skulls. Human whole blood clots (3 hours incubation) could be lysed within less than 30 seconds and in absence of further lytic agents. Thrombolysis efficacy was dependent on transskull signal absorption, acoustic output power and flow conditions and differed widely between a minimum of 6.21% and a maximum of 77.26%. Transskull insonation with HIFU did not lead to significant focus beam distortion. Conclusions: The use of transskull HIFU for immediate clot lysis without the need of further drugs and disregarding individual skull bone characteristics is feasible in vitro.


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