Proper blood flow in and out of the brain is essential for its proper functioning. A thrombus or blood clot in a blood vessel in the brain can cause strokes and strokes. Hemorrhage is life-threatening, and the death of neurons from lack of oxygen and nutrients can lead to severe disabilities. Thrombi are the enemy and a scientific team from North Carolina State University (NCSU) has created the ultimate weapon to eliminate them: a tool that creates a sonic tornado capable of breaking down blood clots in the brain.

WHAT IS THE ULTRASOUND VORTEX?

The tool consists of a transducer specially designed to create a swirling and vortex effect using ultrasound. The device is also small enough to fit inside a catheter, which doctors can insert through the circulatory system to the location of the blood clot. To test the technology, the researchers created a 3D-printed model of the cerebral venous sinus, where they placed a cow blood clot.

The ultrasonic “tornado” offers a faster solution in in vitro models of cerebral venous sinus thrombosis (CVST) than currently available existing techniques for removing clots (the system has not yet been tested in people). “Based on available data, pharmaceutical interventions to dissolve CVST blood clots take at least 15 hours and an average of around 29 hours,” reports Professor Shi. “During in vitro testing, we were able to dissolve an acute blood clot in less than half an hour.” In this way, the damage caused by stroke and bleeding could be greatly reduced.

“Our previous work looked at various techniques that use ultrasound to remove blood clots using what are essentially forward-propelled waves,” explains Xiaoning Jiang, co-author of the study in a statement from the university. “Our new work uses vortex ultrasound, where the ultrasound waves have a helical wavefront.”

“In other words, ultrasound swirls as it goes,” says Xiaoning, professor of mechanical and aerospace engineering at NCSU. “Based on our in vitro tests, this approach removes blood clots more quickly than existing techniques, largely due to vortex wave-induced shear stress.”

“The fact that our new technique works quickly is important, because CVST clots increase pressure on blood vessels in the brain,” adds Chengzhi Shi, co-author of the paper and assistant professor of mechanical engineering at Georgia Tech. “This increases the risk of bleeding in the brain, which can be catastrophic for patients.”

“Existing techniques rely heavily on interventions that dissolve the blood clot. But this is a time-consuming process. Our approach has the potential to address these clots more quickly, reducing the risk to patients.”

“Another reason why our work here is important is that current treatments for TSVC fail in 20-40% of cases,” says Professor Xiaoning.

CASES OF BLOOD CLOTS IN THE BRAIN ARE INCREASING

CVSTs occur when a clot forms inside the veins responsible for draining blood out of the brain. CVST incidence rates were between two and three per 100,000 people in the United States in 2018 and 2019, but the incidence rate appears to be increasing since then.

There is always a risk of damage during any catheterization or intervention, but the new tool may cause fewer injuries than other options. For example, it could damage the blood vessel itself.

To allay this concern, the study authors conducted a series of experiments by applying vortex ultrasound to samples of animal blood veins. Those tests produced no evidence of damage inflicted on blood vessel walls. Further tests were performed to assess whether vortex ultrasound caused significant damage to red blood cells, but no substantial damage was observed.

“The next step is for us to conduct tests using an animal model to better establish the feasibility of this technique for CVST treatment,” says Professor Jiang. “If those trials are successful, we look forward to continuing clinical trials.” The study has been published in the journal Research.

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