4.8 Article

Noninvasive high-intensity focused ultrasound treatment of twin-twin transfusion syndrome: A preliminary in vivo study

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SCIENCE TRANSLATIONAL MEDICINE
卷 8, 期 347, 页码 -

出版社

AMER ASSOC ADVANCEMENT SCIENCE
DOI: 10.1126/scitranslmed.aaf2135

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资金

  1. Action Medical Research [GN2052]
  2. Isaac Newton Trust
  3. Genesis Research Trust
  4. Focused Ultrasound Foundation Centers of Excellence
  5. British Heart Foundation
  6. National Institute for Health Research (NIHR) Biomedical Research Centre based at Imperial College Healthcare National Health Service (NHS) Trust
  7. Imperial College London
  8. Action Medical Research [2052] Funding Source: researchfish
  9. Biotechnology and Biological Sciences Research Council [BB/E002668/1, 992201] Funding Source: researchfish
  10. British Heart Foundation [RG/06/006/22028, FS/12/74/29778, PG/10/99/28656, PG/14/5/30547, RG/11/16/29260] Funding Source: researchfish
  11. Cancer Research UK [16464] Funding Source: researchfish
  12. Engineering and Physical Sciences Research Council [EP/N026942/1] Funding Source: researchfish
  13. BBSRC [BB/E002668/1] Funding Source: UKRI
  14. EPSRC [EP/N026942/1] Funding Source: UKRI

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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.

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