Blocked-flow vs. free-flow cyanoacrylate glue embolization: Histological differences in an in vivo rabbit renal artery model.

Autor: Comby PO; Department of Neuroradiology and Emergency Radiology, Image-Guided Therapy Center, François-Mitterrand University Hospital, 21079 Dijon, France; ICMUB Laboratory, UMR CNRS 6302, Université de Bourgogne, 21000 Dijon, France., Guillen K; ICMUB Laboratory, UMR CNRS 6302, Université de Bourgogne, 21000 Dijon, France; Department of Vascular and Interventional Radiology, Image-Guided Therapy Center, François-Mitterrand University Hospital, 21079 Dijon, France., Chevallier O; ICMUB Laboratory, UMR CNRS 6302, Université de Bourgogne, 21000 Dijon, France; Department of Vascular and Interventional Radiology, Image-Guided Therapy Center, François-Mitterrand University Hospital, 21079 Dijon, France., Couloumy E; R&D, Guerbet Research, 95943 Roissy Charles-de-Gaulle, France., Dencausse A; R&D, Guerbet Research, 95943 Roissy Charles-de-Gaulle, France., Robert P; R&D, Guerbet Research, 95943 Roissy Charles-de-Gaulle, France., Catoen S; R&D, Guerbet Research, 95943 Roissy Charles-de-Gaulle, France., Salsac AV; Biomechanics and Bioengineering Laboratory, UMR CNRS 7338, Université de Technologie de Compiègne, 60203 Compiègne, France., Aho-Glele SL; Department of Epidemiology, Statistics and Clinical Research, François-Mitterrand University Hospital, 21079 Dijon, France., Loffroy R; ICMUB Laboratory, UMR CNRS 6302, Université de Bourgogne, 21000 Dijon, France; Department of Vascular and Interventional Radiology, Image-Guided Therapy Center, François-Mitterrand University Hospital, 21079 Dijon, France. Electronic address: romaric.loffroy@chu-dijon.fr.
Jazyk: angličtina
Zdroj: Diagnostic and interventional imaging [Diagn Interv Imaging] 2024 Apr; Vol. 105 (4), pp. 137-143. Date of Electronic Publication: 2023 Nov 08.
DOI: 10.1016/j.diii.2023.10.003
Abstrakt: Purpose: The purpose of this in vivo animal study was to compare the acute histological effects on the arterial vessel wall of free-flow vs. blocked-flow embolization with metacryloxysulfolane-n‑butyl cyanoacrylate (MS-NBCA) in several concentrations.
Materials and Methods: A total of 42 rabbit renal arteries were embolized using MS-NBCA mixed with ethiodized oil. The MS-NBCA concentration was 12.5%, 25%, or 50%. All mixtures were injected under both free-flow and blocked-flow conditions. The rabbits were euthanised 30 min after arterial embolization. Arterial-lumen distension, intimal inflammation and necrosis, peri‑arterial edema, and distality of MS-NBCA penetration were assessed histologically. Multivariable regression analyses were performed using a manual backward procedure, with linear, ordinal and logistic regression to search for factors associated with these outcomes RESULTS: Marked or severe dilatation was observed in 36 out of 42 arteries (86%) and marked or transmural intimal arteritis in all 42 arteries (42/42; 100%). Lumen dilatation caused focal vessel-wall flattening, which resulted in intimal necrosis. Multifocal necrosis extending from the intima to the media occurred in 23 out of 42 kidneys (55%) and peri‑arterial edema with multifocal vascular leakage in 19 out of 42 kidneys (45%). At multivariable analysis, blocked-flow MS-NBCA injection was associated with greater severity of vessel-wall lesions, including intimal arteritis (P = 0.003) and intimal necrosis (P = 0.014), compared to free-flow injection. Blocked-flow injection was also associated with peri‑arterial edema (P = 0.008) and greater distality of MS-NBCA penetration (P = 0.001).
Conclusion: Blocked-flow MS-NBCA injection during renal artery embolization is significantly associated with more acute arterial-wall damage and greater distality of glue penetration compared to free-flow injection in a rabbit model. These preliminary findings may have clinical implications, as blocked-flow injection is routinely used to treat specific vascular diseases or malformations in human.
Competing Interests: Declaration of Competing Interest The experiments were performed at the R&D Department of the Guerbet Corporation. The rabbits and Lipiodol Ultra Fluid® were founded by Guerbet (Villepinte, France). Guerbet had no role in data collection, analysis, or interpretation, manuscript drafting or revision. Emilie Couloumy, Anne Dencausse, Philippe Robert, Sarah Catoen are employees of Guerbet.
(Copyright © 2023 Société française de radiologie. Published by Elsevier Masson SAS. All rights reserved.)
Databáze: MEDLINE
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