Strain Ultrasound Elastography of Aneurysm Sac Content after Randomized Endoleak Embolization with Sclerosing vs. Non-sclerosing Chitosan-based Hydrogels in a Canine Model.

Autor:	Sivakumaran L; Laboratoire clinique du traitement de l'image, Centre de recherche du Centre hospitalier de l'Université de Montréal, Montréal, Québec, Canada; Université de Montréal, Montréal, Québec, Canada; Department of Diagnostic Radiology, McGill University, Montréal, Québec, Canada., Alturkistani H; Laboratoire clinique du traitement de l'image, Centre de recherche du Centre hospitalier de l'Université de Montréal, Montréal, Québec, Canada; King Khalid University Hospital, Radiology and Medical Imaging Department, Riyadh, Riyadh, Saudi Arabia., Lerouge S; Laboratoire de biomatériaux endovasculaires, Centre de recherche du Centre hospitalier de l'Université de Montréal, Montréal, Québec, Canada; Département de génie mécanique, École de technologie supérieure, Department of Mechanical Engineering, Montréal, Québec, Canada., Bertrand-Grenier A; Laboratoire clinique du traitement de l'image, Centre de recherche du Centre hospitalier de l'Université de Montréal, Montréal, Québec, Canada; Laboratoire de biorhéologie et d'ultrasonographie médicale, Centre de recherche du Centre hospitalier de l'Université de Montréal, Montréal, Québec, Canada; Université de Montréal, Montréal, Québec, Canada; Département de chimie, biochimie et physique, Université du Québec à Trois-Rivières, Trois-Rivières, Québec, Canada., Zehtabi F; Laboratoire de biomatériaux endovasculaires, Centre de recherche du Centre hospitalier de l'Université de Montréal, Montréal, Québec, Canada., Thérasse É; Department of Radiology, Centre hospitalier de l'Université de Montréal, Montréal, Québec, Canada., Roy-Cardinal MH; Laboratoire de biorhéologie et d'ultrasonographie médicale, Centre de recherche du Centre hospitalier de l'Université de Montréal, Montréal, Québec, Canada., Bhatnagar S; McGill University, Montréal, Québec, Canada., Cloutier G; Laboratoire de biorhéologie et d'ultrasonographie médicale, Centre de recherche du Centre hospitalier de l'Université de Montréal, Montréal, Québec, Canada., Soulez G; Laboratoire clinique du traitement de l'image, Centre de recherche du Centre hospitalier de l'Université de Montréal, Montréal, Québec, Canada; Department of Radiology, Centre hospitalier de l'Université de Montréal, Montréal, Québec, Canada. Electronic address: gilles.soulez.med@ssss.gouv.qc.ca.
Jazyk:	angličtina
Zdroj:	Journal of vascular and interventional radiology : JVIR [J Vasc Interv Radiol] 2022 May; Vol. 33 (5), pp. 495-504.e3. Date of Electronic Publication: 2022 Feb 09.
DOI:	10.1016/j.jvir.2022.02.003
Abstrakt:	Purpose: To compare the mechanical properties of aneurysm content after endoleak embolization with a chitosan hydrogel (CH) with that with a chitosan hydrogel with sodium tetradecyl sulfate (CH-STS) using strain ultrasound elastography (SUE). Materials and Methods: Bilateral common iliac artery type Ia endoleaks were created in 9 dogs. Per animal, 1 endoleak was randomized to blinded embolization with CH, and the other, with CH-STS. Brightness-mode ultrasound, Doppler ultrasound, SUE radiofrequency ultrasound, and computed tomography were performed for up to 6 months until sacrifice. Radiologic and histopathologic studies were coregistered to identify 3 regions of interest: the embolic agent, intraluminal thrombus (ILT), and aneurysm sac. SUE segmentations were performed by 2 blinded independent observers. The maximum axial strain (MAS) was the primary outcome. Statistical analysis was performed using the Fisher exact test, multivariable linear mixed-effects models, and intraclass correlation coefficients (ICCs). Results: Residual endoleaks were identified in 7 of 9 (78%) and 4 of 9 (44%) aneurysms embolized with CH and CH-STS, respectively (P = .3348). CH-STS had a 66% lower MAS (P < .001) than CH. The ILT had a 37% lower MAS (P = .01) than CH and a 77% greater MAS (P = .079) than CH-STS. There was no significant difference in ILT between treatments. The aneurysm sacs embolized with CH-STS had a 29% lower MAS (P < .001) than those embolized with CH. Residual endoleak was associated with a 53% greater MAS (P < .001). The ICC for MAS was 0.807 (95% confidence interval: 0.754-0.849) between segmentations. Conclusions: CH-STS confers stiffer intraluminal properties to embolized aneurysms. Persistent endoleaks are associated with increased sac strain, an observation that may help guide management. (Copyright © 2022 SIR. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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