Busting clots in children’s blood vessels

Children who have cancer or other conditions that require long-term catheters, shunts or tubes are always in danger of developing blood clots. And that can lead to stroke.

Shelby Kutty, M.D., assistant professor of pediatric cardiology, wants to non-invasively blast those clots apart layer by layer, “like peeling an onion.”

Dr. Kutty investigates how microbubbles and guided three-dimensional ultrasound impulses can dissolve blood clots in children, while 3-D ultrasound imaging shows the process in real time.

This breakthrough technique has earned Dr. Kutty early career investigator awards and grants from the American Society of Echocardiography, the American College of Cardiology and the American Heart Association.

Tom Porter, M.D., professor of cardiology at UNMC, perfected the technique in adults and has mentored Dr. Kutty with this new application. “His work in pediatrics is unique,” Dr. Porter said. “No one else is doing this anywhere in the world right now.”

Dr. Kutty also wants to use the technology to prevent the clotting off of grafts and shunts in kidney and cancer patients. And he’s collaborating with Dr. Porter and Irving H. Zucker, Ph.D., professor and chairman, cellular/integrative physiology, to investigate the use of microbubbles and ultrasound to break up abnormal growth to treat infections in the heart. The group also is investigating the success of this treatment to relieve groin artery spasm and improve blood flow after heart catheterization.

All of the projects are at the animal model stage, but clinical trials for the pediatric project may be just two years away.

“This would be a huge breakthrough because the clot-busting drugs we use on adults can cause torrential bleeding in children,” Dr. Kutty said.

“Kids need their own therapies,” he said. “They’re not just little big people.”