Focused Ultrasound Therapy
Focused ultrasound is a rapidly evolving, noninvasive, therapeutic technology with the potential to improve the quality of life and decrease the cost of care for patients with arteriovenous malformations (AVMs). This novel technology focuses beams of ultrasound energy precisely and accurately on targets deep in the body without damaging surrounding normal tissue.
How it Works
The mechanism of action that is being studied is thermal ablation of the AVM, which has been done on the extremity of a patient. There is also some preclinical work looking at using a mechanical (non-thermal) ablation on the malformation.
Advantages
The primary options for treatment of AVMs includes surgery although some less invasive medicines or procedures can be chosen if the lesion is in a poor surgical location. For certain patients, focused ultrasound could provide a noninvasive alternative to surgery with less risk of complications – such as like surgical wound healing or infection – at a lower cost. Focused ultrasound can reach the desired target without damaging surrounding tissue, and it can be repeated, if necessary.
Clinical Trials
At the present time, there are no clinical trials recruiting patients for focused ultrasound AVM treatments.
Regulatory Approval and Reimbursement
Focused ultrasound treatment for AVM is not yet approved by regulatory bodies or covered by medical insurance companies.
Notable Papers
Calik J, Zawada T, Bove T. Treatment of superficial benign vascular tumors by high intensity focused ultrasound: Observations in two illustrative cases. J Cosmet Dermatol. 2022 Aug;21(8):3371-3379. doi: 10.1111/jocd.14682. Epub 2021 Dec 17.
Jones J, Bolding M, Ullman H, Kaneko N, Tateshima S. Focused Ultrasound Ablation of an Arteriovenous Malformation Model. Front Neurol. 2021 Jun 3;12:671380. doi: 10.3389/fneur.2021.671380. eCollection 2021.
Liu JL, Lin XL, Zhou H, Pan JH, Liu GH, Shuai HL, Xin-Luo. Ultrasound-guided high-intensity focused ultrasound as pretreatment before surgical excision for fertility-preserving management of uterine arteriovenous malformation. Eur J Obstet Gynecol Reprod Biol. 2019 Jul 22. pii: S0301-2115(19)30357-4. doi: 10.1016/j.ejogrb.2019.07.030.
Ghanouni P, Kishore S, Lungren MP, Bitton R, Chan L, Avedian R, Bazzocchi A, Butts Pauly K, Napoli A, Hovsepian DM. Treatment of Low-Flow Vascular Malformations of the Extremities Using MR-Guided High Intensity Focused Ultrasound: Preliminary Experience. Vasc Interv Radiol. 2017 Dec;28(12):1739-1744. doi: 10.1016/j.jvir.2017.06.002.
Yan X, Zhao C, Tian C, Wen S, He X, Zhou Y. Ultrasound-guided high-intensity focused ultrasound ablation for treating uterine arteriovenous malformation. BJOG. 2017 Aug;124 Suppl 3:93-96. doi: 10.1111/1471-0528.14749.
van Breugel JM, Nijenhuis RJ, Ries MG, Toorop RJ, Vonken EJ, Wijlemans JW, van den Bosch MA. Non-invasive magnetic resonance-guided high intensity focused ultrasound ablation of a vascular malformation in the lower extremity: a case report. J Ther Ultrasound. 2015 Dec 30;3:23. doi: 10.1186/s40349-015-0042-7.
Hoerig CL1, Serrone JC1, Burgess MT1, Zuccarello M1, Mast TD1. Prediction and suppression of HIFU-induced vessel rupture using passive cavitation detection in an ex vivo model. J Ther Ultrasound. 2014 Sep 8;2:14. doi: 10.1186/2050-5736-2-14. eCollection 2014.
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