Investigating the potential of catheter‐assisted pulsed focused ultrasound ablation for atherosclerotic plaques

• Published in: Medical physics (Lancaster) 2024-08, Vol.51 (8), p.5181-5189
• Main Authors: Samaddar, Abhirup, Singh, Rohit, Yang, Xinmai, Ebersole, Koji C., Forrest, M. Laird
• Format: Article
• Language: English
• Subjects: Animals; atherosclerosis; catheter; Catheters; cavitation; focused ultrasound; High-Intensity Focused Ultrasound Ablation - instrumentation; Humans; Phantoms, Imaging; Plaque, Atherosclerotic; Swine
• ISSN: 0094-2405; 2473-4209; 2473-4209
• DOI: 10.1002/mp.17253

Background Atherosclerosis is a condition in which an adhesive substance called plaque accumulates over time inside the arteries. Plaque buildup results in the constriction of arteries, causing a shortage of blood supply to tissues and organs. Removing atherosclerotic plaques controls the development of acute ischemic stroke and heart diseases. It remains imperative for positive patient outcomes. Purpose This study sought to develop a minimally invasive technique for removing arterial plaques by applying focused ultrasound (FUS) energy on the metal surface of a nitinol catheter wire to induce inertial cavitation. The induced cavitation can deplete plaque mechanically inside the arteries, leading towards improved recanalization of blood vessels. Methods The enhanced cavitation effect induced by combining FUS with a metal catheter was first verified by exposing agar phantom gels with or without a 0.9‐mm diameter nitinol wire to an acoustic field produced by a 0.5‐MHz FUS transducer. The phenomenon was further confirmed in pork belly fat samples with or without a 3‐mm diameter nitinol catheter wire. Cavitation was monitored by detecting the peaks of emitted ultrasound signals from the samples using a passive cavitation detector (PCD). Cavitation threshold values were determined by observing the jump in the peak amplitude of signals received by the PCD when the applied FUS peak negative pressure (PNP) increased. To simulate arterial plaque removal, FUS with or without a catheter was used to remove tissues from pork belly fat samples and the lipid cores of human atherosclerotic plaque samples using 2500‐cycle FUS bursts at 10% duty cycle and a burst repetition rate of 20 Hz. Treatment outcomes were quantified by subtracting the weight of samples before treatment from the weight of samples after treatment. All measurements were repeated 5 times (n = 5) unless otherwise indicated, and paired t‐tests were used to compare the means of two groups. A p‐value of