Noninvasive high-intensity focused ultrasound treatment of twin-twin transfusion syndrome: a preliminary in vivo study
File(s)aaf2135_technical edit.docx (136.88 KB)
Accepted version
Author(s)
Type
Journal Article
Abstract
We investigated the efficacy, maternofetal responses, and safety of using high-intensity focused ultrasound (HIFU) for noninvasive occlusion of placental vasculature compared to sham treatment in anesthetized pregnant sheep. This technique for noninvasive occlusion of placental vasculature may be translatable to the treatment of conditions arising from abnormal placental vasculature, such as twin-twin transfusion syndrome (TTTS). Eleven pregnant sheep were instrumented with maternal and fetal arterial catheters and time-transit flow probes to monitor cardiovascular, acid-base, and metabolic status, and then exposed to HIFU (n = 5) or sham (n = 6) ablation of placental vasculature through the exposed uterine surface. Placental vascular flow was occluded in 28 of 30 targets, and histological examination confirmed occlusion in 24 of 30 targets. In both HIFU and sham exposures, uterine contact reduced maternal uterine artery flow, but delivery of oxygen and glucose to the fetal brain remained normal. HIFU can consistently occlude in vivo placental vessels and ablate blood flow in a pregnant sheep model. Cardiovascular and metabolic fetal responses suggest that the technique is safe in the short term and potentially translatable to human pregnancy.
Date Issued
2016-07-13
Date Acceptance
2016-06-13
Citation
Science Translational Medicine, 2016, 8 (347), pp.1-11
ISSN
1946-6242
Publisher
American Association for the Advancement of Science
Start Page
1
End Page
11
Journal / Book Title
Science Translational Medicine
Volume
8
Issue
347
Copyright Statement
This is the author’s version of the work. It is posted here by permission of the AAAS for personal use, not for redistribution. The definitive version was published in Science Translational Medicine on Volume 8 number 347 and 13 July 2016, DOI: 10.1126/scitranslmed.aaf2135
Sponsor
Genesis Research Trust
Action Medical Research
Identifier
PII: 8/347/347ra95
Grant Number
DPCH3440
GN2052
Subjects
Science & Technology
Life Sciences & Biomedicine
Cell Biology
Medicine, Research & Experimental
Research & Experimental Medicine
UTERINE BLOOD-FLOW
ARTERIOVENOUS ANASTOMOSES
VASCULAR ANASTOMOSES
PREGNANT SHEEP
ACID-BASE
FETAL
ISOFLURANE
RESPONSES
ANESTHESIA
OCCLUSION
Animals
Brain
Female
Fetofetal Transfusion
Fetus
Glucose
High-Intensity Focused Ultrasound Ablation
Oxygen
Pregnancy
Sheep
Brain
Fetus
Animals
Sheep
Fetofetal Transfusion
Oxygen
Glucose
Pregnancy
Female
High-Intensity Focused Ultrasound Ablation
06 Biological Sciences
11 Medical and Health Sciences
Publication Status
Published
Article Number
347ra95