Gentric J C, Raymond J, Batista A, Salazkin I, Gevry G, Darsaut T E
From the Department of Radiology (J.C.G., J.R., A.B.), Centre Hospitalier de l'Université de Montréal, Notre-Dame Hospital, Montreal, Quebec, Canada Equipe d'Accueil 3878 - Groupe d'Etude de la Thrombose en Bretagne Occidentale (J.C.G.), Université de Bretagne Occidentale, Brest, France.
From the Department of Radiology (J.C.G., J.R., A.B.), Centre Hospitalier de l'Université de Montréal, Notre-Dame Hospital, Montreal, Quebec, Canada Laboratory of Interventional Neuroradiology (J.R., I.S., G.G.), Centre Hospitalier de l'Université de Montréal, Notre-Dame Hospital Research Centre, Montreal, Quebec, Canada.
AJNR Am J Neuroradiol. 2015 May;36(5):977-81. doi: 10.3174/ajnr.A4211. Epub 2015 Jan 15.
Liquid embolic agents are increasingly used to treat vascular malformations. We sought to assess embolization with these agents by using a dual-lumen balloon catheter in an experimental setting.
Eighteen injections of liquid embolic agents were performed in the rete mirabile of swine. We used 3 methods to control liquid embolic agent reflux: 1) dual-lumen balloon-catheter (group A, n = 8); 2) injection of liquid embolic agent after proximal n-BCA plug formation through a second microcatheter (group B, n = 4); and 3) standard liquid embolic agent injection (group C, controls, n = 6). The following outcomes were graded by using ordinal scales by angiography, macrophotography, and radiography of retia after euthanasia: 1) angiographic and pathologic extent of liquid embolic agent embolization of the rete, 2) reflux of liquid embolic agents in the parent artery, and 3) density of liquid embolic agents in the proximal rete. Technical complications were also recorded. A successful injection was defined as an embolization that reached the contralateral rete without reflux into proximal external branches. Exact logistic regression analyses were performed to compare groups.
There were significant differences among groups for reflux (P = .029) and liquid embolic agent density in the proximal rete (P = .014), while extension to the contralateral rete did not reach statistical significance (P = .07). Injections differed among groups (P = .004), with dual-lumen balloon-catheter injections more frequently successful compared with control injections (P = .019).
Dual-lumen balloon catheters allowed better liquid embolic agent injections than standard injections.
液体栓塞剂在治疗血管畸形中的应用日益广泛。我们试图在实验环境中使用双腔球囊导管评估这些栓塞剂的栓塞效果。
在猪的奇网中进行了18次液体栓塞剂注射。我们采用3种方法控制液体栓塞剂反流：1）双腔球囊导管（A组，n = 8）；2）通过第二根微导管在近端n-BCA栓塞形成后注射液体栓塞剂（B组，n = 4）；3）标准液体栓塞剂注射（C组，对照组，n = 6）。在安乐死后，通过血管造影、宏观摄影和奇网X线摄影，使用有序量表对以下结果进行分级：1）奇网液体栓塞剂栓塞的血管造影和病理范围，2）液体栓塞剂在母动脉中的反流，3）近端奇网中液体栓塞剂的密度。同时记录技术并发症。成功注射定义为栓塞剂到达对侧奇网且无反流至近端外部分支。进行精确逻辑回归分析以比较各组。
各组在反流（P = 0.029）和近端奇网中液体栓塞剂密度（P = 0.014）方面存在显著差异，而延伸至对侧奇网未达到统计学意义（P = 0.07）。各组注射情况不同（P = 0.004），与对照注射相比，双腔球囊导管注射更常成功（P = 0.019）。
与标准注射相比，双腔球囊导管能实现更好的液体栓塞剂注射。
