Department of Radiology, The First Affiliated Hospital of Guangzhou Medical University, 151 Yanjiangxi Road, Guangzhou, 510120, People's Republic of China.
Department of Interventional Therapy, Dongguan People's Hospital, Dongguan, 523059, People's Republic of China.
Cardiovasc Intervent Radiol. 2019 Aug;42(8):1183-1191. doi: 10.1007/s00270-019-02224-7. Epub 2019 May 1.
To evaluate the level of artery occlusion, degradation periods, tissue response and vessel recanalization of calibrated gelatin sponge particles after segmental renal artery embolization.
Superselective embolization of 14 adult rabbits was performed with calibrated gelatin sponge particles (150-350 μm). Two rabbits were killed immediately after the procedure (day 0). One pair of rabbits was killed on each of the following days: 1, 3, 7, 14, 28 and 56. One rabbit from each pair underwent CT angiography before embolization and killing. The pathologic changes of the embolized renal parenchyma and embolic characteristics of calibrated gelatin sponge particles were evaluated histologically and angiographically.
Calibrated gelatin sponge particles were distally located in interlobular artery with a dense packing on day 0. The level of occlusion paralleled the size of the particles. Partial degradation of the particles was observed on day 3, and complete degradation was observed on day 14. Vessel recanalization was observed through both CTA and histological analysis starting on day 3. Vascular inflammation responding to gelatin sponge particles was mild and subsided with the degradation of the particles. On day 28 and day 56, attenuation of embolized vessels occurred due to marked intimal proliferation, and vascular occlusion developed.
Gelatin sponge particles of 150-350 μm produced dense and distal embolization, and were resorbed before day 14 with a mild tissue reaction. Vessel recanalization occurred secondary to the resorption of gelatin sponge particles, but permanent vascular occlusion developed due to marked intimal hyperplasia after day 28.
评价肾段动脉栓塞后标定明胶海绵颗粒的动脉闭塞程度、降解时间、组织反应和血管再通情况。
对 14 只成年兔进行超选择性栓塞,使用标定明胶海绵颗粒(150-350μm)。栓塞后即刻处死 2 只兔子(第 0 天)。随后,每天处死一对兔子:第 1、3、7、14、28 和 56 天。每对兔子栓塞前和处死前均行 CT 血管造影。评估栓塞肾实质的病理变化和标定明胶海绵颗粒的栓塞特征。
第 0 天,标定明胶海绵颗粒位于小叶间动脉的远端,呈密集排列。闭塞程度与颗粒大小一致。第 3 天可见部分颗粒降解,第 14 天完全降解。第 3 天开始通过 CTA 和组织学分析观察到血管再通。对明胶海绵颗粒的血管炎症反应较轻,随着颗粒的降解而消退。第 28 天和第 56 天,由于内膜明显增生,栓塞血管衰减,血管闭塞发生。
150-350μm 的明胶海绵颗粒可产生致密的远端栓塞,在第 14 天之前被吸收,伴有轻度组织反应。明胶海绵颗粒吸收后发生血管再通,但第 28 天后由于内膜明显增生,导致永久性血管闭塞。