ABSTRACT
Several small clinical studies have demonstrated that application of ultrasound using an
endovascular catheter can recanalize occluded arterial vessels. The devices all use a wire
operating between 19.5 and 45 kHz at high energy, resulting in direct mechanical or cavitational
fragmentation of the thrombus. Careful catheter guidance is essential and vessel damage and
perforation can occur. Studies are underway using lower intensity ultrasound delivered either by
catheter or noninvasively in combination with fibrinolytic agents to accelerate thrombolysis. This
approach will expose the vessel to lower intensities of ultrasonic energy, and the noninvasive
transcutaneous application of ultrasound would simplify the approach.
