Microbubble Potentiated Ultrasound as a Method of Declotting Thrombosed Dialysis Grafts: Experimental Study in Dogs

Abstract

Intravenous perfluorocarbon-exposed sonicated dextrose albumin (PESDA) microbubbles in the presence of low frequency ultrasound (LFUS) can lyse very small clots. We develop a similar method to declot full-size arteriovenous dialysis grafts. Dialysis grafts fashioned in three dogs were cannulated and ligated. After thrombosis, three declotting techniques were randomly applied: 1) direct injection of PESDA + LFUS; 2) direct injection of saline + LFUS; and 3) intravenous PESDA + LFUS. Declotting was graded by cine angiography scores of each third of the graft on a scale of 0-4 (maximum total score = 12). Twenty-six procedures showed mean patency scores of 11.1 for direct PESDA and 8.4 for IV PESDA, vs 4.9 for direct saline, p =