School of Medicine, Laboratory of Physiopathology and Vascular Therapeutics, Hôpital La Timone, 27 boulevard Jean Moulin, 13385 Marseille cedex 5, France.
J Vasc Interv Radiol. 2010 Sep;21(9):1419-23. doi: 10.1016/j.jvir.2010.04.026. Epub 2010 Aug 3.
To investigate in a porcine experimental model the effectiveness, tissue penetration, and histologic impact of renal artery embolization with a collagen-based nonadhesive embolic agent, marsembol.
Fifteen pigs underwent embolization of one interlobular artery of the renal artery with collagen-resorcinol gel emulsified with Lipiodol and further polymerized with glutaraldehyde-formaldehyde mixture. Angiograms were obtained before, during, and after the procedure. Animals were euthanized at day 0 (n = 3), 1 week (n = 3), or 3 months (n = 7), and flat-panel three-dimensional rotational radiologic images of the kidneys were obtained. Arterial, medullary, and cortical samples were taken for histologic and scanning electron microscopic investigations.
Fifteen interlobular renal arteries were successfully embolized by delivering 1.7 mL + or - 0.2 of the embolic agent. All the embolized arteries remained occluded at 3 months, leading to a major atrophy of the embolized portions of the kidneys. Imaging and histologic findings show that the embolic agent provided a distal vessel occlusion and entirely filled the lumen of the arteries up to the glomerular tufts. The homogeneous plug formed by the embolic agent induces very few inflammatory responses. The regenerative tubular processes were arrested at 3 months.
The collagen-based embolic agent described here has the properties required to perform embolization. These specific properties lead to very distal vessel embolization. The embolic agent is effective at 3 months in renal embolization.
在猪实验模型中研究使用基于胶原蛋白的非粘性栓塞剂 marsembol 进行肾动脉栓塞的有效性、组织穿透性和组织学影响。
15 头猪的一条肾叶间动脉接受胶原-间苯二酚凝胶与碘化油乳化并进一步用戊二醛-甲醛混合物聚合的栓塞治疗。在手术前、手术中和手术后进行血管造影。动物在第 0 天(n = 3)、第 1 周(n = 3)或第 3 个月(n = 7)处死,获得肾脏的平板三维旋转放射影像学图像。采集动脉、髓质和皮质样本进行组织学和扫描电子显微镜检查。
通过输送 1.7 毫升 +/-0.2 的栓塞剂成功栓塞了 15 条肾叶间动脉。所有栓塞的动脉在 3 个月时仍然闭塞,导致栓塞肾脏部分的严重萎缩。影像学和组织学发现表明,栓塞剂提供了远端血管闭塞,并完全填充了动脉的腔直至肾小球丛。由栓塞剂形成的均匀塞子引起的炎症反应很少。在 3 个月时,再生的管状过程被阻止。
这里描述的基于胶原蛋白的栓塞剂具有进行栓塞所需的特性。这些特性导致非常远端的血管栓塞。栓塞剂在 3 个月时对肾动脉栓塞有效。