Osuga Keigo, Anai Hiroshi, Takahashi Masahide, Miyayama Shiro, Yamagami Takuji, Sone Miyuki, Nakamura Hironobu
Dept. of Diagnostic and Interventional Radiology, Osaka University Graduate School of Medicine.
Gan To Kagaku Ryoho. 2009 Mar;36(3):437-42.
Liver abscess formation has been recently concerned after hepatic arterial embolization using porous gelatin particles( Gelpart)(GP), and inhomogeneous particles size or fragmentation of GP may partly contribute to this complication. The purpose of this study was to investigate the size distribution and incidence of fragments of GP before and after microcatheter passage. 1 mm- and 2 mm-GP were injected into three microcatheters with different inner-diameters by three interventional radiologists. The particles were stained with methylene blue dye, and the longer- and shorter-particle diameters were measured by a digital microscope. The particles less than 300 microm and 600 microm in longer- diameter was defined as fragment for 1 mm- and 2 mm-GP, respectively. Diameter of GP showed a wide bimodal distribution by fragments and non-fragment particles. The change of mean particle diameter ranged within 10%, and the ratio of shorter- to longer-particle diameter remained similarly at 0.75. The incidence of fragments was approximately 10% and 5% before microcatheter passage and increased by one-two times and two-five times after microcatheter passage for 1 mm- and 2 mm-GP, respectively. In conclusion, GP were ununiform in particle size distribution and contained fragments. GP did not change in shape significantly after microcatheter passage, however, 2 mm-GP was more prone to fragmentation than 1 mm-GP.
使用多孔明胶颗粒(Gelpart,GP)进行肝动脉栓塞后,肝脓肿形成近来受到关注,而GP颗粒大小不均一或破碎可能部分导致了这一并发症。本研究的目的是调查微导管通过前后GP的大小分布及碎片发生率。三名介入放射科医生将1毫米和2毫米的GP注入三根内径不同的微导管。颗粒用亚甲蓝染料染色,并用数字显微镜测量颗粒的较长和较短直径。较长直径小于300微米和600微米的颗粒分别被定义为1毫米和2毫米GP的碎片。GP的直径通过碎片和非碎片颗粒呈现出广泛的双峰分布。平均粒径变化范围在10%以内,较短与较长粒径之比同样保持在0.75。微导管通过前碎片发生率分别约为10%和5%,对于1毫米和2毫米的GP,微导管通过后碎片发生率分别增加了一到两倍和两到五倍。总之,GP的粒径分布不均匀且含有碎片。微导管通过后GP的形状没有明显变化,然而,2毫米的GP比1毫米的GP更容易破碎。