Volume Changes of Experimental Carotid Sidewall Aneurysms Due to Embolization with Liquid Embolic Agents: A Multidetector CT Angiography Study

Autor: Oliver Dudeck, E. Weigang, Eric Doelker, Daniel A. Rüfenacht, Olivier Jordan, M. Pech, Ali Fuat Okuducu, K. Tesmer, Roland Felix
Rok vydání: 2006
Předmět:
Time Factors
Intracranial Pressure
Swine
medicine.medical_treatment
Balloon Occlusion/adverse effects
chemistry.chemical_compound
Occlusion
Image Processing
Computer-Assisted
Embolization
ddc:615
medicine.diagnostic_test
Ultrasound
Dilatation
Pathologic/etiology/radiography
Cerebrovascular Circulation
cardiovascular system
Female
ddc:500
Radiology
Artifacts
Cardiology and Cardiovascular Medicine
Dilatation
Pathologic
medicine.medical_specialty
Carotid Artery
Common
Chemoembolization
Therapeutic/adverse effects
Carotid Artery
Common/pathology/physiopathology/radiography/surgery
Polyvinyl Alcohol/administration & dosage/adverse effects/metabolism
Silicone
Aneurysm
medicine
Animals
Radiology
Nuclear Medicine and imaging
cardiovascular diseases
Chemoembolization
Therapeutic
Foreign-Body Reaction/etiology/pathology/physiopathology/radiography
business.industry
Foreign-Body Reaction
Angiography
Digital Subtraction
Intracranial Aneurysm
Intracranial Aneurysm/physiopathology/radiography/therapy
Balloon Occlusion
medicine.disease
Disease Models
Animal
chemistry
Volume (thermodynamics)
Polyvinyl Alcohol
Angiography
Foreign body
business
Tomography
Spiral Computed
Follow-Up Studies
Zdroj: Cardiovascular and Interventional Radiology, Vol. 29, No 6 (2006) pp. 1053-9
ISSN: 1432-086X
0174-1551
DOI: 10.1007/s00270-005-2361-5
Popis: Iodine-containing polyvinyl alcohol polymer (I-PVAL) is a novel precipitating liquid embolic that allows for artifact-free evaluation of CT angiography (CTA). As accurate aneurysm volumetry can be performed with multidetector CTA, we determined volumes of experimental aneurysms before, immediately after, and 4 weeks after embolization of 14 porcine experimental carotid sidewall aneurysms with this liquid embolic. An automated three-dimensional software measurement tool was used for volumetric analysis of volume-rendering CTA data. Furthermore, intra-aneurysmal pressure changes during liquid embolization were measured in four silicone aneurysms and potential polymer volume changes within 4 weeks were assessed in vitro. Liquid embolic injection was performed during temporary balloon occlusion of the aneurysm neck, resulting in a mean occlusion rate of 98.3%. Aneurysms enlarged significantly during embolization by 61.1 +/- 28.9%, whereas a significant shrinkage of 5.6 +/- 2.7% was observed within the follow-up period. Histologic analysis revealed an inflammatory foreign body reaction with partial polymer degradation. In silicone aneurysm models, intra-aneurysmal pressure remained unchanged during liquid embolic injection, whereas balloon inflation resulted in a mean pressure increase of 31.2 +/- 0.7%. No polymer shrinkage was observed in vitro. The aneurysm enlargement noted was presumably due to pressure elevation after balloon inflation, which resulted in dilatation of the weak venous wall of the newly constructed aneurysm--another shortcoming of this experimental aneurysm model. The volume decrease after 4 weeks expressed partial polymer degradation.
Databáze: OpenAIRE
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