Research Article: Control of fibrinolytic drug injection via real-time ultrasonic monitoring of blood coagulation

Date Published: February 27, 2019

Publisher: Public Library of Science

Author(s): Dmitry A. Ivlev, Shakhla N. Shirinli, Konstantin G. Guria, Svetlana G. Uzlova, Georgy Th. Guria, Alexander V. Panfilov.


In the present study, we investigated the capabilities of a novel ultrasonic approach for real-time control of fibrinolysis under flow conditions. Ultrasonic monitoring was performed in a specially designed experimental in vitro system. Fibrinolytic agents were automatically injected at ultrasonically determined stages of the blood clotting. The following clots dissolution in the system was investigated by means of ultrasonic monitoring. It was shown, that clots resistance to fibrinolysis significantly increases during the first 5 minutes since the formation of primary micro-clots. The efficiency of clot lysis strongly depends on the concentration of the fibrinolytic agent as well as the delay of its injection moment. The ultrasonic method was able to detect the coagulation at early stages, when timely pharmacological intervention can still prevent the formation of macroscopic clots in the experimental system. This result serves as evidence that ultrasonic methods may provide new opportunities for real-time monitoring and the early pharmacological correction of thrombotic complications in clinical practice.

Partial Text

Monitoring and timely correction of hemostasis is a crucial medical task [1, 2]. A number of severe thrombotic pathologies, such as myocardial infarction and stroke, might occur suddenly and develop very rapidly [3, 4]. In these cases large thrombi occluding blood flow in major arteries can be formed during several minutes [4]. That is why prompt and efficient techniques for hemostasis monitoring are needed.

Presently, ultrasonic methods are already used rather widely in the field of thrombosis and hemostasis, for instance, in the diagnostics of deep vein thrombosis [31, 32], the detection of thrombi in the left atrial appendage [33] and the monitoring of intravascular emboli [34]. Taking into account the recent achievements in the development of implantable ultrasonic sensors [35] it seems quite likely that, eventually, an ultrasonic technique for the monitoring of blood coagulation and thrombi formation inside the human body will be created.




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