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HIFU is already approved in parts of the world for treating prostate cancer, while clinical trials are underway to use it to treat liver and kidney cancer. For cancer treatment, the tumor tissue is ablated using the HIFU.
Applying it to bleeding seems like a sensible next step, says Gail ter Haar, a physicist at the Institute of Cancer Research's Therapeutic Ultrasound Team in the Royal Marsden Hospital, near London. "It is ambitious but it's quite realizable," she says.
Surrounding tissue may be damaged in the process, since it will be heated close to the boiling point. But the blood vessels remain functional because "the blood flow in the vessel cools the wall and so protects it," says ter Haar. So the blood around the opening coagulates, while the blood passing through the vessels keeps on flowing.
The biological feasibility of this technology is well established, says Joseph Eichinger, president of Seattle-based AcousTx, which was spun out of another company, Therus, to take part in DARPA's research program. Therus, also in Seattle, has also been developing ways to use ultrasound to stop bleeding. In particular, its acoustic hemostasis system is being developed to seal punctures in the femoral artery of the groin that are caused as part of cardiac catheter treatments. Normally, these punctures have to have continuous pressure applied to them, and can take from 30 minutes to several hours to seal, says Eichinger. With the HIFU approach, they seal in just a few seconds.
In its final form, the acoustic cuff will consist of a lightweight, flexible device with both ultrasonic imaging transducers and therapeutic transducers lining its insides. The imaging transducers, which function in the same way as sonograms, will be used to first identify the vasculature within a limb and locate any bleeds. The therapeutic transducers are then focused to stem the blood flow.
All
these capabilities have been demonstrated as separate parts, says
Eichinger -- now comes the engineering hurdle of putting them together
in a package capable of surviving the rigors of a battlefield. "It is a
very challenging environment," he says. "It's hard enough to take an
iPod into Iraq and make it work." Indeed, the heat, humidity, dust, and
noisy electromagnetic environment of combat couldn't be further from a
safe and clean hospital treatment room.
A revolutionary new approach to neurosurgery avoids both radiation and a scalpel.
A polymer-filled pouch that expands when exposed to blood can quickly halt bleeding.
Guest (Richard)
If the army don't develop this idea, nobody will. This technology can bring many new possibilities in the future.
50 milion is less than the US government pays in interest everyday...
Guest (Kat)
Oh, Baby, this is medical Star Wars. This is not a new idea at all, and if it showed promise there is a little branch of the government called the NIH that is designed to fund suff like this. Hmmm, 50 mil would bankroll 100 scientists with some really inventive ideas, with $500K project grants. If this is a good idea, why does Phillips need money from the government to study it? And if this was a REALLY good idea, them smart venture capitalist dogs would already be funding it….
Guest (gerry)
Nope, this is a DARPA issue, not an NIH issue. Different foci, but the citizens will win in the end if it works. As pointed out earlier, if we're spending $50M that's really small potatoes to the Feds, even if it's make one of my projects go on, like, forever.
Since I've been in the trenches with cutting edge medical research (sorry, I just couldn't say "bleeding edge") I've a little bit of a feel for some of the things that show promise. I think this is one of 'em.
Guest (Rodrigo)
That way wounded soldiers could be detected really easy as ultrasonic sounds can be heard with special devices. Its just a thought ^o)
Guest (Salsa Shark)
Isn't this thing gonna hurt like hell. There has to be a les painful way to heal somone, like couldn't they just make like a hemoglobin shot or something.
I have to say it being the humanitarian I am, why ar ethey using it for war first anyway. This could be the difference between walking outside and stay couped up indoors to little hypocondriac children.
Guest (gerry)
So it hurts. We've got drugs to help with that. "Hurts" beats "dead" every time.
Guest (spankey)
So did the bullet and/or bomb that caused the need for the device in the first place. Geez you guys, this is a fantastic advancement in medicine if it works out.
Guest (Mike)
The "Golden Hour" becomes redundant
This is a fascinating project with real applications in the civilian world. Any paramedic will acknowledge that intra-thoracic or intra-abdominal haemorrhages result in a patient's death due to blood loss that cannot be controlled. Time to urgent surgical intervention is the only solution to stop the haemorrhage. A device described above really does promise the "Holy Grail" for paramedic practice for the future by being able to stop the clock on the "Golden Hour". Diagnostic ultrasound is already available for prehospital use in small hand-held devices. One should remember that the world's first "portable" defibrillator (developed in Northern Ireland in the early 1970's) weighed 90kg and had to be dragged around on a hand trolley. Now they are the size of a personal CD player and can be fully automatic.
Guest (Inyerface)
Howdy! Not on the defibrilator that came out of Ireland but the Medical Anti Shock Trouser. Covers the abdomen and legs. Pumped up with air causes internal pressure increase to collapse internal vessels. Incearces blood pressure centrally but does not replace surgery to stem blood loss either veinous loss or arterial loss. Also injurous when removed incorrectly or outside of surgery.
Guest (Mike)
Yes, I liked using the MAST and found it to be useful in a select number of patients. It was certainly not a solution to haemorrhage control though. It offered a temporary means of raising mean arterial pressure, but did so while effectively exacerbating blood loss from the internal site of injury. Not so good. Current evidence from medical research has now lead to its "fall from grace". So we certainly need something to control haemorrhage without the application of pneumatic counter-pressure. This program sounds very exciting indeed.
They are targeting this due to a large body of growing experience using hi frequency focused ultrasound energy (HFUS)-- the prime current use is in MRI guided destruction of tumors (including gynecologic fibroids). Energy can be stereotactic localized to melt tumors this here is logical next step. A noninvasive approach to vessel embolization. wwww.docinthemachine.com
Manufacturing in the United States is in trouble. That's bad news not just for the country's economy but for the future of innovation.
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Guest (mark)
another way to do it
How about using microwaves to cauterise leaking blood vessels.
Using a real time imaging system with an electronically steerable microwave beam could conceiveably achieve whole of body cauterisation. Surely all of the work on hi-tech radars and medical imaging could make this possible. Not just for the military but for civilian use as well. thanks.
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Guest (mARK)
not easy
microwave generators are much larger and more power hungry. not something a medic can have a bunch of in his pack.
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Guest (gman)
Microwaves will not work, but this project is probably still an enormous misuse of taxpayer money
Ultrasound is a far superior choice for focusing in the body and converting acoustic energy to heat and/or causing damage by mechanical means. However, the ability to first find bleeding and then reliably cauterize the vessel has never been demonstrated in an extremely controlled setting, much less a battlefield. In fact results have been quite variable. At the moment this is a lot of money being tossed at a very speculative project…there are much more promising techniques that better deserve this money.
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Guest (jhuan)
That's right
Support the above suspect.
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Guest (maumas)
the more money you spend, the more money you can steal
thats how it works
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Guest (dogbert)
Magic Pill
It would be a better idea to give out magic pills that instantly diagnose and treat in the field without the need of any medical training whatsoever, and could be developed for a mere 49 million. They will be lighter, the end of the study will yield similar results, and the government saves 2 mil.
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Guest (gerry)
re: another way to do it
But, the idea isn't to truly cauterize and disrupt function of the vessel. With HIFU the vessel walls generally will remain viable. With microwave RF cautery, they won't.
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