Noninvasive high-intensity focused ultrasound treatment of twin-twin transfusion syndrome: A preliminary in vivo study.
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Embargo End Date
ICR Authors
Authors
Shaw, CJ
Civale, J
Botting, KJ
Niu, Y
Ter Haar, G
Rivens, I
Giussani, DA
Lees, CC
Civale, J
Botting, KJ
Niu, Y
Ter Haar, G
Rivens, I
Giussani, DA
Lees, CC
Document Type
Journal Article
Date
2016-07-13
Date Accepted
2016-06-13
Abstract
We investigated the efficacy, maternofetal responses, and safety of using high-intensity focused ultrasound (HIFU) for noninvasive occlusion of placental vasculature compared to sham treatment in anesthetized pregnant sheep. This technique for noninvasive occlusion of placental vasculature may be translatable to the treatment of conditions arising from abnormal placental vasculature, such as twin-twin transfusion syndrome (TTTS). Eleven pregnant sheep were instrumented with maternal and fetal arterial catheters and time-transit flow probes to monitor cardiovascular, acid-base, and metabolic status, and then exposed to HIFU (n = 5) or sham (n = 6) ablation of placental vasculature through the exposed uterine surface. Placental vascular flow was occluded in 28 of 30 targets, and histological examination confirmed occlusion in 24 of 30 targets. In both HIFU and sham exposures, uterine contact reduced maternal uterine artery flow, but delivery of oxygen and glucose to the fetal brain remained normal. HIFU can consistently occlude in vivo placental vessels and ablate blood flow in a pregnant sheep model. Cardiovascular and metabolic fetal responses suggest that the technique is safe in the short term and potentially translatable to human pregnancy.
Citation
Science translational medicine, 2016, 8 (347), pp. 347ra95 - ?
Source Title
Publisher
AMER ASSOC ADVANCEMENT SCIENCE
ISSN
1946-6234
eISSN
1946-6242
Collections
Research Team
Imaging for Radiotherapy Adaptation
Therapeutic Ultrasound
Therapeutic Ultrasound