Document Detail


Prostate histotripsy in an anticoagulated model.
MedLine Citation:
PMID:  19931897     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: To further explore the phenomenon of minimal bleeding after histotripsy by performing extensive prostate histotripsy treatments in anticoagulated canines. Histotripsy is a noninvasive ultrasound technology which induces microbubble formation (cavitation) within tissues producing mechanical tissue fractionation. During initial in vivo feasibility canine studies of prostate ablation, minimal hematuria was observed.
METHODS: Histotripsy was performed on 9 canine subjects pretreated with 6 mg of oral warfarin for 3-5 days using an extracorporeal 750 kHz therapeutic ultrasound transducer delivering acoustic pulses to the prostatic urethra and periurethral parenchyma. After 7-28 days, the subjects were euthanized, transrectal prostate ultrasound was performed, and the prostate was harvested. Serum hemoglobin and International Normalization Ratio were measured immediately before histotripsy treatment and at euthanasia.
RESULTS: Mean treatment International Normalization Ratio was 4.6 (median, 2.4; range, 1.2-11.3). There was no clinically significant change in hemoglobin concentration at euthanasia compared with baseline. At harvest, histologic sections of the prostate revealed a large cavity corresponding to the planned treatment volume incorporating the prostatic urethra and parenchyma in all subjects. Urine was clear within 2 days of treatment, and no blood clots were seen.
CONCLUSIONS: Despite therapeutic and supratherapeutic anticoagulation, histotripsy resulted in minimal bleeding despite significant fractionation and tissue debulking of the prostate. These results have prompted further studies to understand the mechanism of nonthermal hemostasis underlying histotripsy.
Authors:
Jeffery C Wheat; Timothy L Hall; Christopher R Hempel; Charles A Cain; Zhen Xu; William W Roberts
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2009-11-22
Journal Detail:
Title:  Urology     Volume:  75     ISSN:  1527-9995     ISO Abbreviation:  Urology     Publication Date:  2010 Jan 
Date Detail:
Created Date:  2010-01-29     Completed Date:  2010-02-22     Revised Date:  2014-09-05    
Medline Journal Info:
Nlm Unique ID:  0366151     Medline TA:  Urology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  207-11     Citation Subset:  IM    
Copyright Information:
2010 Elsevier Inc. All rights reserved.
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MeSH Terms
Descriptor/Qualifier:
Animals
Anticoagulants / administration & dosage
Dogs
Hemorrhage / etiology*,  prevention & control*
Male
Prostate* / pathology
Ultrasonic Therapy / adverse effects*
Warfarin / administration & dosage
Grant Support
ID/Acronym/Agency:
1K08DK081656-01/DK/NIDDK NIH HHS; K08 DK081656/DK/NIDDK NIH HHS; K08 DK081656-01/DK/NIDDK NIH HHS
Chemical
Reg. No./Substance:
0/Anticoagulants; 5Q7ZVV76EI/Warfarin
Comments/Corrections

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