{"doi":"10.1016/j.eng.2024.03.021","title":"Rotational Intravascular Multidirectional Ultrasound Catheter for Sonothrombolysis of Retracted Clots: An in Vitro and in Vivo Study","abstract":"Thromboembolism in blood vessels poses a serious risk of stroke, heart attack, and even sudden death if not properly managed. Sonothrombolysis combined with ultrasound contrast agents has emerged as a promising approach for the effective treatment of thromboembolism. Recent reports have highlighted the potential of intravascular sonothrombolysis as a safe and effective treatment modality for deep vein thrombosis (DVT). However, its efficiency has not been validated through in vivo testing of retracted clots. This study aimed to develop a miniaturized multidirectional transducer featuring two 4-layer lead zirconate titanate (PZT-5A) stacks with an aperture size of 1.4 mm × 1.4 mm, enabling both forward- and side-looking treatment. Integrated into a custom two-lumen 10-French (Fr) catheter, the capability of this device for intravascular sonothrombolysis was validated both in vitro and in vivo. With low-dose tissue plasminogen activators and nanodroplets, the rotational multidirectional transducer reduced the retracted clot mass (800 mg) by an average of 52% within 30 min during in vitro testing. The lysis rate was significantly higher by 37% than that in a forward-viewing transducer without rotation. This improvement was particularly noteworthy in the treatment of retracted clots. Notably, a long-retracted clot (> 10 cm) was successfully treated within 40 min in vivo by creating a flow channel with a diameter > 4 mm in a porcine DVT model. In conclusion, these findings strongly suggest the potential of this technique for clinical applications in sonothrombolysis, offering a feasible solution for effectively treating thromboembolism, particularly in challenging cases involving retracted clots.","journal":"Engineering","year":2024,"id":446966,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":6,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9508,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2024-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":348380,"name":"Jinwook Kim","orcid":"0000-0002-2072-3922","position":1,"is_corresponding":false},{"id":502784,"name":"Bohua Zhang","orcid":"0000-0002-9329-0507","position":2,"is_corresponding":false},{"id":775917,"name":"Gabe E. Owens","orcid":"0000-0002-6823-0764","position":3,"is_corresponding":false},{"id":775915,"name":"Greyson Stocker","orcid":"0000-0001-7241-899X","position":4,"is_corresponding":false},{"id":702201,"name":"Mengyue Chen","orcid":"0000-0002-6482-5381","position":5,"is_corresponding":false},{"id":1259660,"name":"Benjamin C. Kreager","orcid":null,"position":6,"is_corresponding":false},{"id":407183,"name":"Ashley Cornett","orcid":"0009-0004-1075-4989","position":7,"is_corresponding":false},{"id":723029,"name":"Kathlyne Jayne B. Bautista","orcid":"0000-0001-9985-6199","position":8,"is_corresponding":false},{"id":892714,"name":"Tarana Parvez Kaovasia","orcid":"0000-0002-1786-8215","position":9,"is_corresponding":false},{"id":292645,"name":"Paul A. Dayton","orcid":"0000-0002-5757-6911","position":10,"is_corresponding":false},{"id":326714,"name":"Zhen Xu","orcid":"0000-0003-0262-3044","position":11,"is_corresponding":false},{"id":325196,"name":"Xiaoning Jiang","orcid":"0000-0003-3605-3801","position":12,"is_corresponding":false},{"id":502782,"name":"Huaiyu Wu","orcid":"0000-0003-2616-1171","position":0,"is_corresponding":true}],"reference_count":47,"raw_metadata":null,"created_at":"2026-07-19T02:01:54.980444Z","pmid":null,"pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}