Document Detail

Ablation of chronic total occlusions using kilohertz-frequency mechanical vibrations in minimally invasive angioplasty procedures.
MedLine Citation:
PMID:  21303322     Owner:  NLM     Status:  In-Data-Review    
Certain minimally invasive cardiology procedures, such as balloon angioplasty and stent implantation, critically require that the site of an arterial blockage be crossed by an intraluminal guidewire. Plaques resulting in near or totally occluded arteries are known as chronic total occlusions, and crossing them with conventional guidewires is a significant challenge. Among the most promising proposed solutions is the delivery of high-power, low-frequency ultrasonic vibrations to the occlusion site via an intraluminal wire waveguide. The vibrating distal tip of the ultrasound wire waveguide is used to transmit energy to the surrounding plaques, tissues, and fluids to ablate or weaken atherosclerotic plaque. Potential mechanisms of interaction with the plaque and adjacent fluids identified in the literature include: (i) direct contact with the waveguide distal tip, (ii) subcavitational acoustic fluid pressure fluctuations, (iii) cavitation, and (iv) acoustic streaming. We summarize developments in this area over more than two decades, describing experimental methods for device performance characterization, preclinical tests, early clinical investigations, and, later, full clinical trials. The article also reviews theoretical foundations and numerical models suitable for device design and analysis. Finally, important issues for future research and for the development of this technology will be considered.
Garrett B McGuinness; M Wylie; G Gavin
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Critical reviews in biomedical engineering     Volume:  38     ISSN:  0278-940X     ISO Abbreviation:  Crit Rev Biomed Eng     Publication Date:  2010  
Date Detail:
Created Date:  2011-02-09     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8208627     Medline TA:  Crit Rev Biomed Eng     Country:  United States    
Other Details:
Languages:  eng     Pagination:  511-31     Citation Subset:  IM    
School of Mechanical and Manufacturing Engineering, Dublin City University, Ireland.
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