Vaezy S, Martin R, Kaczkowski P, Keilman G, Goldman B, Yaziji H, Carter S, Caps M, Crum L
Department of Bioengineering, University of Washington, Seattle, USA.
J Vasc Surg. 1999 Mar;29(3):533-42. doi: 10.1016/s0741-5214(99)70282-x.
High-intensity focused ultrasound (HIFU) has been shown to be effective in controlling hemorrhage from punctures in blood vessels. The objective of the current study was to investigate the capability of HIFU to stop bleeding after a more severe type of vascular injury, namely longitudinal incisions of arteries and veins.
The superficial femoral arteries, common femoral arteries, carotid arteries, and jugular veins of four anesthetized pigs were exposed surgically. A longitudinal incision, 2 to 8 mm in length, was produced in the vessel. HIFU treatment was applied within 5 seconds of the onset of the bleeding. The HIFU probe consisted of a high-power, 3.5-MHz, piezoelectric transducer with an ellipsoidal focal spot that was 1 mm in cross section and 9 mm in axial dimension. The entire incision area was scanned with the HIFU beam at a rate of 15 to 25 times/second and a linear displacement of 5 to 10 mm. A total of 76 incisions and HIFU treatments were performed.
Control of bleeding (major hemosatsis) was achieved in all 76 treatments, with complete hemostasis achieved in 69 treatments (91%). The average treatment times of major and complete hemostasis were 17 and 25 seconds, respectively. After the treatment, 74% of the vessels in which complete hemostasis was achieved were patent with distal blood flow and 26% were occluded. The HIFU-treated vessels showed a consistent coagulation of the adventitia surrounding the vessels, with a remarkably localized injury to the vessel wall. Extensive fibrin deposition at the treatment site was observed.
HIFU may provide a useful method of achieving hemostasis for arteries and veins in a variety of clinical applications.
高强度聚焦超声（HIFU）已被证明在控制血管穿刺出血方面有效。本研究的目的是调查HIFU在更严重类型的血管损伤（即动脉和静脉的纵向切口）后止血的能力。
对四只麻醉猪的股浅动脉、股总动脉、颈动脉和颈静脉进行手术暴露。在血管上制作一个长度为2至8毫米的纵向切口。在出血开始后5秒内进行HIFU治疗。HIFU探头由一个高功率、3.5兆赫兹的压电换能器组成，其椭圆形焦点的横截面为1毫米，轴向尺寸为9毫米。用HIFU束以每秒15至25次的速率和5至10毫米的线性位移扫描整个切口区域。共进行了76次切口和HIFU治疗。
在所有76次治疗中均实现了出血控制（主要止血），69次治疗（91%）实现了完全止血。主要止血和完全止血的平均治疗时间分别为17秒和25秒。治疗后，实现完全止血的血管中74%通畅且有远端血流，26%闭塞。经HIFU治疗的血管显示血管周围外膜一致凝固，血管壁损伤明显局限。在治疗部位观察到广泛的纤维蛋白沉积。
HIFU可能为各种临床应用中的动脉和静脉止血提供一种有用的方法。
