Contrast-enhanced ultrasound-guided high intensity focused ultrasound treatment of grade 4 liver lacerations in a swine model.
Publication/Presentation Date
12-1-2025
Abstract
BACKGROUND: We aimed to demonstrate the feasibility of using contrast-enhanced ultrasound (CEUS)-guided high intensity focused ultrasound (HIFU) for the rapid identification and treatment of active bleeding from liver lacerations in a swine model.
METHODS: A two-element HIFU transducer was coupled to a probe and scanner for coregistered diagnostic imaging and ablation. Contrast imaging was performed for vessel targeting and bleeding identification. Eight swine received a 2 × 2 cm laceration across a superficial hepatic vein to induce active hemorrhage. Animals were then randomized to receive either CEUS imaging alone or CEUS-guided HIFU treatment. Subsequently, lacerations were created in an additional eight swine, treated with CEUS-guided HIFU, and followed for 24 hours.
RESULTS: Control animals did not achieve hemostasis, while all swine treated with CEUS-guided HIFU achieved hemostasis within 60 seconds of treatment and had less blood loss (60 mL; interquartile range [IQR], 40-125 mL vs. 725 mL; IQR, 410-925 mL; p = 0.016). For the survival studies, hemostasis was achieved after 2 to 6, 45-second treatment cycles (median, 2.5 treatments). The average total blood loss in the survival cohort was 105 mL (IQR, 41-325 mL). There were no changes in vital signs between the pre- and postlaceration control ( p > 0.10). No changes were observed in blood cell counts prelaceration and 24 hours posthemostasis ( p > 0.25). Importantly, all animals survived for the full 24-hour monitoring period. On gross pathologic examination, no apparent damage was detected in the adjacent organs or liver ducts.
CONCLUSION: This preclinical study suggests that CEUS-guided HIFU is a promising tool for the noninvasive rapid identification and subsequent treatment of active bleeding from liver lacerations.
Volume
99
Issue
6
First Page
955
Last Page
961
ISSN
2163-0763
Published In/Presented At
Fall, F., Eisenbrey, J. R., Tam, A., Contreras, K., Maxwell, A., Vlaisavljevich, E., Liu, J. B., Kuon Yeng Escalante, C., Siu Xiao, T., Mohammed, A., Forsberg, F., Goldberg, A., & Koenig, G. (2025). Contrast-enhanced ultrasound-guided high intensity focused ultrasound treatment of grade 4 liver lacerations in a swine model. The journal of trauma and acute care surgery, 99(6), 955–961. https://doi.org/10.1097/TA.0000000000004737
Disciplines
Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods
PubMedID
40611378
Department(s)
Administration and Leadership
Document Type
Article