Published: 31 December 2012

Low frequency and high intensity ultrasound in vascular surgery: theory, instrumentation and possibilities of clinical application

A. Bubulis1
I. Adzerikho2
D. Stepanenko3
V. Minchenya4
M. Valaika5
V. Veikutis6
A. Pranskunas7
R. Unikas8
K. Morkunaite9
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This paper presents a brief review of applications of ultrasound in modern surgery and results of original studies of the authors in the field of application of low frequency (24-36 kHz) high-intensity (up to 20 W/cm2) ultrasonic vibrations for disruption of thrombi and calcified atherosclerotic plaques in blood vessels. Application of non-rigid wire ultrasonic waveguides with length up to 980 mm and diameter of working tip down to 0.3 mm enables minimally invasive surgical intervention, since a waveguide can be introduced along curved segments of blood vessels through a small incision situated at substantial distance from occlusion. Ultrasonic angioplasty can be successfully applied in combination with administration of thrombolytic drugs. The paper also considers physical mechanisms of thrombus disruption under influence of ultrasonic vibrations, particularly, effects of cavitation and acoustic streaming. We described design of ultrasonic waveguides for endovascular surgery and their manufacturing technology based on plasma-electrolytic etching. Application of finite element method and transfer matrix approach for design and model of wire waveguides is considered. Description of clinical system for ultrasonic angioplasty with automated resonance tuning of a waveguide is also provided. In addition, we report results of clinical application of ultrasonic angioplasty in patients with occlusion of iliofemoral segment.

About this article

20 October 2012
04 December 2012
31 December 2012
low-frequency ultrasonic vibrations
finite element method
thrombolytic therapy