Brush Kelli, Chaudry Hannah, Berry Natalia, Young Michael N, Devries James, Friend Lynsy, Kane Jesse, Rothstein Eric
Heart and Vascular Center at Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA.
University of Vermont Medical Center, Burlington, Vermont, USA.
JACC Case Rep. 2025 Jul 23;30(20):104174. doi: 10.1016/j.jaccas.2025.104174.
Intravenous sonothrombolysis is an emerging strategy for management of acute coronary syndromes. This involves intravenous administration of echocardiographic ultrasound enhancing agents with subsequent ultrasound-induced microbubble rupture using echocardiography. However, it is challenging to isolate a specific cardiac distribution. We sought to overcome this with targeted coronary sonothrombolysis.
In a case of acute coronary syndrome with extensive thrombus burden, targeted coronary sonothrombolysis was performed with perflutren microbubbles injected directly into the thrombus and subsequently ruptured using echocardiography, leading to significant reduction in thrombus burden and normalization of coronary flow.
Injection of perflutren microbubbles into the thrombus with subsequent opacification of only the myocardium supplied by the infarct-related artery is an effective means to deliver therapy to the appropriate location.
TAKE-HOME MESSAGE: Targeted coronary sonothrombolysis helps overcome some of the difficulties observed with sonothrombolysis and may be a novel technique for management of coronary thrombus.
静脉内超声溶栓是一种用于治疗急性冠脉综合征的新兴策略。这包括静脉注射超声心动图超声增强剂，随后使用超声心动图使微泡破裂。然而，分离特定的心脏分布具有挑战性。我们试图通过靶向冠状动脉超声溶栓来克服这一问题。
在一例急性冠脉综合征且血栓负荷广泛的病例中，使用全氟丙烷微泡直接注射到血栓中进行靶向冠状动脉超声溶栓，随后使用超声心动图使其破裂，导致血栓负荷显著降低且冠状动脉血流恢复正常。
将全氟丙烷微泡注射到血栓中，随后仅使梗死相关动脉供血的心肌显影，是将治疗输送到合适部位的有效方法。
靶向冠状动脉超声溶栓有助于克服超声溶栓中观察到的一些困难，可能是一种治疗冠状动脉血栓的新技术。
