1. Precision Targeted Ablation of Fine Neurovascular Structures In Vivo Using Dual-mode Ultrasound Arrays
- Author
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H. Brent Clark, Rajagopal N. Aravalli, John W. Osborn, Parker O’Brien, Dalong Liu, Hasan Aldiabat, Dusty Van Helden, M. Gerard O'Sullivan, Emad S. Ebbini, and Alexandru Flaviu Tăbăran
- Subjects
Male ,Mean arterial pressure ,medicine.medical_specialty ,lcsh:Medicine ,030204 cardiovascular system & hematology ,Article ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,Spontaneously hypertensive rat ,In vivo ,Rats, Inbred SHR ,Internal medicine ,Animals ,Medicine ,lcsh:Science ,Denervation ,Carotid Body ,Multidisciplinary ,Vital Signs ,business.industry ,Ultrasound ,lcsh:R ,Neurovascular bundle ,Electrical and electronic engineering ,Rats ,Blood pressure ,Surgery, Computer-Assisted ,Preclinical research ,Hypertension ,Breathing ,Cardiology ,High-Intensity Focused Ultrasound Ablation ,lcsh:Q ,business ,Biomedical engineering - Abstract
Carotid bodies (CBs) are chemoreceptors that monitor and register changes in the blood, including the levels of oxygen, carbon dioxide, and pH, and regulate breathing. Enhanced activity of CBs was shown to correlate with a significant elevation in the blood pressure of patients with hypertension. CB removal or denervation were previously shown to reduce hypertension. Here we demonstrate the feasibility of a dual-mode ultrasound array (DMUA) system to safely ablate the CB in vivo in a spontaneously hypertensive rat (SHR) model of hypertension. DMUA imaging was used for guiding and monitoring focused ultrasound (FUS) energy delivered to the target region. In particular, 3D imaging was used to identify the carotid bifurcation for targeting the CBs. Intermittent, high frame rate imaging during image-guided FUS (IgFUS) delivery was used for monitoring the lesion formation. DMUA imaging provided feedback for closed-loop control (CLC) of the lesion formation process to avoid overexposure. The procedure was tolerated well in over 100 SHR and normotensive rats that received unilateral and bilateral treatments. The measured mean arterial pressure (MAP) exhibited measurable deviation from baseline 2–4 weeks post IgFUS treatment. The results suggest that the direct unilateral FUS treatment of the CB might be sufficient to reduce the blood pressure in hypertensive rats and justify further investigation in large animals and eventually in human patients.
- Published
- 2020
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