Focused Ultrasound Therapy
Focused ultrasound is an early-stage, noninvasive, therapeutic technology with the potential to improve the quality of life and decrease the cost of care for patients with intracerebral hemorrhage. This novel technology focuses beams of ultrasound energy precisely and accurately on targets deep in the brain without damaging surrounding normal tissue.
How it Works
The mechanisms of action are that where the beams converge, focused ultrasound produces several therapeutic effects that are being evaluated. One mechanism is the disruption of blood clots, which allows reperfusion of ischemic tissue. Another mechanism is the temporarily opening the blood-brain barrier which enables entry of stem cells into the area of the stroke that can repopulate the area. All are still in the early stage and more work is needed before this research can reach the clinic. Please note that there is another major cause of stroke, listed separately under “Stroke, thromboembolic.”
The primary options for treatment of intracerebral hemorrhage include medications with the possible inclusion of surgery.
For certain patients, focused ultrasound could provide a noninvasive alternative to surgery with less risk of complications – such as surgical wound healing or infection – at a lower cost. It can reach the desired target without damaging surrounding tissue and is repeatable, if necessary.
At the present time, there are no clinical trials recruiting patients for focused ultrasound treatment of of intracerebral hemorrhage.
Regulatory Approval and Reimbursement
Focused ultrasound treatment for intracerebral hemorrhage is not yet approved by regulatory bodies or covered by medical insurance companies.
Lee J, Chang WS, Shin J, Seo Y, Kong C, Song BW, Na YC, Kim BS, Chang JW. Non-invasively enhanced intracranial transplantation of mesenchymal stem cells using focused ultrasound mediated by overexpression of cell-adhesion molecules. Stem Cell Res. 2020 Jan 30;43:101726. doi: 10.1016/j.scr.2020.101726.
Gerhardson T, Sukovich JR, Chaudhary N, Chenevert TL, Ives K, Hall TL, Camelo-Piragua S, Xu Z, Pandey AS. Histotripsy Clot Liquefaction in a Porcine Intracerebral Hemorrhage Model. Neurosurgery. 2019 Mar 29. pii: nyz089. doi: 10.1093/neuros/nyz089.
Ilyas A, Chen CJ, Ding D, Romeo A, Buell TJ, Wang TR, Kalani MYS, Park MS. Magnetic resonance-guided, high-intensity focused ultrasound sonolysis: potential applications for stroke. Neurosurg Focus. 2018 Feb;44(2):E12. doi: 10.3171/2017.11.FOCUS17608.
Yang W, Zhou Y. Effect of pulse repetition frequency of high-intensity focused ultrasound on in vitro thrombolysis. Ultrason Sonochem. 2017 Mar;35(Pt A):152-160. doi: 10.1016/j.ultsonch.2016.09.014.
Harnof S, Zibly Z, Hananel A, Monteith S, Grinfeld J, Schiff G, Kulbatski I, Kassell N. Potential of Magnetic Resonance-guided Focused Ultrasound for Intracranial Hemorrhage: An In Vivo Feasibility Study. J Stroke Cerebrovasc Dis. 2014 Jul;23(6):1585-91.
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