Non-touch, Quick Destruction of the Tracheal Occluding Balloon Using HIFU

The technique of fetal endoscopic tracheal occlusion (FETO) was developed to totally occlude the fetal trachea using an intratracheal balloon in the treatment of congenital diaphragmatic hernia with lung hypoplasia. To improve this approach, we developed a method for non-contact, rapid destruction of the balloon using high intensity focused ultrasound (HIFU), a speci c balloon injection uid, and euthanized rabbits (1 kg). In an initial experiment (5 rabbits), we in ated an intratracheal balloon by injecting in 1.0 ml of uid and demonstrated that HIFU could successfully burst the balloon in all cases, although the tracheal membranous portion and the skin overlying the trachea were injured in 4 and 2 cases, respectively. In our second experiment (6 animals), we in ated the balloon using only 0.5-0.6 ml of fluid. In all cases, HIFU either burst (1 animal) or deflated (5 animals) the balloon and there was substantially decreased injury of the tracheal membranous portion (2 cases) or overlying skin (2 cases). The total HIFU energy output revealed no signi cant difference between the rst and second experimental groups. In conclusion, the intratracheal balloon placed by FETO can be removed using HIFU alone.

胎儿内镜下气管闭塞术（FETO）是通过在气管内放置球囊完全闭塞胎儿气管，用于治疗伴有肺发育不良的先天性膈疝。为了改进这种方法，我们开发了一种利用高强度聚焦超声（HIFU）、一种特殊的球囊注射液以及安乐死的兔子（1千克）进行非接触式快速破坏球囊的方法。在初步实验（5只兔子）中，我们通过注入1.0毫升液体使气管内球囊膨胀，并证明HIFU在所有情况下都能成功使球囊破裂，尽管分别有4例和2例出现气管膜部和气管上方皮肤损伤。在我们的第二次实验（6只动物）中，我们仅使用0.5 - 0.6毫升液体使球囊膨胀。在所有情况下，HIFU要么使球囊破裂（1只动物）要么使球囊放气（5只动物），并且气管膜部（2例）或上方皮肤（2例）的损伤显著减少。HIFU的总能量输出在第一组和第二组实验组之间没有显著差异。总之，FETO放置的气管内球囊可以仅使用HIFU移除。