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 extravascular hematomas. This novel technology focuses beams of ultrasound energy precisely and accurately on targets deep in the brain without damaging surrounding normal tissue. Where the beams converge, the ultrasound produces precise ablation (histotripsy of the fibers within the hematoma) enabling the hematoma to be treated with fine needle aspiration instead of surgery. While early results are promising, there is still much to be done before this technology will be widely available.
The primary options for treatment of hematomas include medication and invasive surgery.
For certain patients, focused ultrasound could provide a noninvasive alternative to surgery with less risk of complications and lower cost.
- Focused ultrasound is noninvasive, so it does not carry added concerns like surgical wound healing or infection.
- Focused ultrasound can reach the desired target without damaging surrounding tissue.
- It can be repeated, if necessary.
At the present time, there are no clinical trials recruiting patients for focused ultrasound treatment of extravascular hematomas.
Regulatory Approval and Reimbursement
Focused ultrasound treatment for extravascular hematomas is not yet approved by regulatory bodies or covered by medical insurance companies.
Boiling histotripsy liquefaction of large extravascular hematomas: in vitro optimization and device design considerations. Presentation by Tanya Khokhlova. 2018
Gerhardson T, Sukovich JR, Pandey AS, Hall TL, Cain CA, Xu Z. Effect of Frequency and Focal Spacing on Transcranial Histotripsy Clot Liquefaction, Using Electronic Focal Steering. Ultrasound Med Biol. 2017 Oct;43(10):2302-2317. doi: 10.1016/j.ultrasmedbio.2017.06.010. Epub 2017 Jul 14.
Khokhlova TD, Monsky WL, Haider YA, Maxwell AD, Wang YN, Matula TJ. Histotripsy Liquefaction of Large Hematomas. Ultrasound Med Biol. 2016 Jul;42(7):1491-8. doi: 10.1016/j.ultrasmedbio.2016.01.020. Epub 2016 Apr 25.
Maxwell AD, Cain CA, Duryea AP, Yuan L, Gurm HS, Xu Z. Noninvasive thrombolysis using pulsed ultrasound cavitation therapy – histotripsy. Ultrasound Med Biol. 2009 Dec;35(12):1982-94. doi: 10.1016/j.ultrasmedbio.2009.07.001. Epub 2009 Oct 24.
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