Thrombin-loaded magnetic microbubbles for the treatment of pseudoaneurysms

The drive toward minimally invasive surgery has yielded multiple benefits for patients but has also increased the incidence of pseudoaneurysms (PSA). The current standard of care is ultrasound-guided thrombin injection to coagulate blood in the PSA sac and seal the ruptured vessel. There is, however...

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Main Authors: Thomas, A, Shieh, B, Bau, L, Lee, R, Handa, A, Stride, E
Format: Journal article
Language:English
Published: Wiley 2022
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author Thomas, A
Shieh, B
Bau, L
Lee, R
Handa, A
Stride, E
author_facet Thomas, A
Shieh, B
Bau, L
Lee, R
Handa, A
Stride, E
author_sort Thomas, A
collection OXFORD
description The drive toward minimally invasive surgery has yielded multiple benefits for patients but has also increased the incidence of pseudoaneurysms (PSA). The current standard of care is ultrasound-guided thrombin injection to coagulate blood in the PSA sac and seal the ruptured vessel. There is, however, a risk of downstream thrombosis if thrombin escapes into the communicating vessel and this limits patient eligibility for thrombin injection. In this study, the feasibility of using magnetic targeting to reduce the risk of distal thrombosis is investigated. Thrombin-loaded magnetic microbubbles are formulated and injected into tissue-mimicking phantoms of PSAs with different geometries using either saline or whole (equine) blood. Ultrasound imaging is used to quantify the concentration of bubbles remaining in the sac with and without application of a custom-built magnetic array. An absorbance-based assay is also used to quantify the concentration of thrombin escaping from the sac. Magnetic targeting enables a significant increase in thrombin retention in all femoral artery PSA models except one, with up to 97% ± 2.5% of the injected thrombin being retained. It is also confirmed that the enzymatic activity of thrombin is maintained, and that clot formation can be successfully achieved in whole blood.
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spelling oxford-uuid:353f221d-a3c8-42cc-9e37-2ce599d186fc2023-05-24T09:41:13ZThrombin-loaded magnetic microbubbles for the treatment of pseudoaneurysmsJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:353f221d-a3c8-42cc-9e37-2ce599d186fcEnglishSymplectic ElementsWiley2022Thomas, AShieh, BBau, LLee, RHanda, AStride, EThe drive toward minimally invasive surgery has yielded multiple benefits for patients but has also increased the incidence of pseudoaneurysms (PSA). The current standard of care is ultrasound-guided thrombin injection to coagulate blood in the PSA sac and seal the ruptured vessel. There is, however, a risk of downstream thrombosis if thrombin escapes into the communicating vessel and this limits patient eligibility for thrombin injection. In this study, the feasibility of using magnetic targeting to reduce the risk of distal thrombosis is investigated. Thrombin-loaded magnetic microbubbles are formulated and injected into tissue-mimicking phantoms of PSAs with different geometries using either saline or whole (equine) blood. Ultrasound imaging is used to quantify the concentration of bubbles remaining in the sac with and without application of a custom-built magnetic array. An absorbance-based assay is also used to quantify the concentration of thrombin escaping from the sac. Magnetic targeting enables a significant increase in thrombin retention in all femoral artery PSA models except one, with up to 97% ± 2.5% of the injected thrombin being retained. It is also confirmed that the enzymatic activity of thrombin is maintained, and that clot formation can be successfully achieved in whole blood.
spellingShingle Thomas, A
Shieh, B
Bau, L
Lee, R
Handa, A
Stride, E
Thrombin-loaded magnetic microbubbles for the treatment of pseudoaneurysms
title Thrombin-loaded magnetic microbubbles for the treatment of pseudoaneurysms
title_full Thrombin-loaded magnetic microbubbles for the treatment of pseudoaneurysms
title_fullStr Thrombin-loaded magnetic microbubbles for the treatment of pseudoaneurysms
title_full_unstemmed Thrombin-loaded magnetic microbubbles for the treatment of pseudoaneurysms
title_short Thrombin-loaded magnetic microbubbles for the treatment of pseudoaneurysms
title_sort thrombin loaded magnetic microbubbles for the treatment of pseudoaneurysms
work_keys_str_mv AT thomasa thrombinloadedmagneticmicrobubblesforthetreatmentofpseudoaneurysms
AT shiehb thrombinloadedmagneticmicrobubblesforthetreatmentofpseudoaneurysms
AT baul thrombinloadedmagneticmicrobubblesforthetreatmentofpseudoaneurysms
AT leer thrombinloadedmagneticmicrobubblesforthetreatmentofpseudoaneurysms
AT handaa thrombinloadedmagneticmicrobubblesforthetreatmentofpseudoaneurysms
AT stridee thrombinloadedmagneticmicrobubblesforthetreatmentofpseudoaneurysms