Ogi Takahiro, Matsui Osamu, Sanada Junichiro, Minami Tetsuya, Kozaka Kazuto, Inoue Dai, Gabata Toshifumi
Department of Radiology, Kanazawa University Graduate School of Medical Science, 13-1 Takaramachi, Kanazawa 920-8640, Japan.
Department of Radiology, Kanazawa University Graduate School of Medical Science, 13-1 Takaramachi, Kanazawa 920-8640, Japan.
J Vasc Interv Radiol. 2014 Apr;25(4):579-585.e2. doi: 10.1016/j.jvir.2013.11.040. Epub 2014 Feb 6.
To evaluate the feasibility and effectiveness of transcatheter embolization by forcible intraarterial injection of a mixture of ethylene vinyl alcohol copolymer (EVAL) and ethanol under microballoon occlusion compared with conventional transcatheter arterial embolization methods in nontumoral swine liver.
Nine swine were divided into three groups: embolization with EVAL/ethanol mixture (EVAL group, n = 5), with ethiodized oil (ethiodized oil group, n = 2), and with microspheres (microspheres group, n = 2). Embolization was performed at the subsegmental hepatic artery. The EVAL/ethanol mixture was injected forcibly through a microcatheter with a balloon, which was inflated to prevent backflow of the mixture during the injection. Ethiodized oil or microspheres were injected into the artery using a microcatheter without balloon occlusion. Two animals of the EVAL group were euthanized immediately after embolization, and the distribution of EVAL was assessed microscopically. The remaining seven animals were euthanized 4 weeks after embolization, and the histopathologic changes were assessed.
All procedures were technically successful. EVAL occupied > 80% of the hepatic arterial, portal venous, and sinusoidal lumens after embolization. Ischemic coagulation necrosis was observed 4 weeks after embolization in the EVAL group. Parenchymal necrosis was not observed in the ethiodized oil and microspheres groups.
Transcatheter embolization by forcible intraarterial injection of an EVAL/ethanol mixture under microballoon occlusion was feasible and achieved the simultaneous embolization of hepatic artery, portal vein, and sinusoids in swine liver, resulting in complete necrosis of the segment that received embolization.
在非肿瘤性猪肝中，评估在微球囊闭塞下经动脉强力注射乙烯-乙烯醇共聚物（EVAL）和乙醇的混合物进行经导管栓塞的可行性和有效性，并与传统经导管动脉栓塞方法进行比较。
将9只猪分为三组：用EVAL/乙醇混合物栓塞（EVAL组，n = 5）、用碘化油栓塞（碘化油组，n = 2）和用微球栓塞（微球组，n = 2）。在肝段下动脉进行栓塞。通过带有球囊的微导管强力注射EVAL/乙醇混合物，球囊膨胀以防止注射过程中混合物回流。使用无球囊闭塞的微导管将碘化油或微球注入动脉。EVAL组的2只动物在栓塞后立即安乐死，并通过显微镜评估EVAL的分布。其余7只动物在栓塞后4周安乐死，并评估组织病理学变化。
所有操作在技术上均获成功。栓塞后EVAL占据了肝动脉、门静脉和肝血窦管腔的80%以上。EVAL组在栓塞后4周观察到缺血性凝固性坏死。碘化油组和微球组未观察到实质坏死。
在微球囊闭塞下经动脉强力注射EVAL/乙醇混合物进行经导管栓塞是可行的，并且在猪肝中实现了肝动脉、门静脉和肝血窦的同时栓塞，导致接受栓塞的节段完全坏死。
