Du Nan, Ma Jingqin, Zhang Zihan, Zhou Yongjie, Yang Minjie, Zhang Wen, Luo Jianjun, Yan Zhiping
Department of Interventional Radiology, Zhongshan Hospital, Fudan University, Shanghai, China.
Shanghai Institution of Medical Imaging, Shanghai, China.
J Clin Transl Hepatol. 2021 Oct 28;9(5):711-718. doi: 10.14218/JCTH.2020.00128. Epub 2021 Jul 7.
Endovascular implantation of iodine-125 (I) seeds strand combined with stent is an effective method of treatment for portal vein tumor thrombosis. The aim of this study was to develop a novel endovascular brachytherapy stent (EVB-Stent) and to evaluate its feasibility of use.
An EVB-Stent was implanted into the main portal vein (MPV) in a live porcine model via the percutaneous transhepatic route. Blood samples were collected and tested before and after operation, as well as before euthanasia. Single-photon emission computed tomography (SPECT) combined with CT (SPECT/CT) scan were performed directly after operation and CT scan was performed 2 months after implantation. After the CT scan was performed, all animals were euthanized and histologically examined.
The novel stent was successfully positioned in all six pigs. No deterioration of liver function was observed during the 2-month follow-up period. SPECT/CT revealed the uniform distribution of radiation around the seeds strand, and the hottest spot was near the center of the MPV. The patency of the stented MPV was confirmed using CT scans. The tissue-accumulated absorbed dose was 31,822.11 mGy at 10 mm transversely away from the midpoint of the I seeds strand, with a half-life of 59.4 days. Pathological examination results showed no significant atrophy or inflammation of adjunct liver tissue, and no obvious intima thickening or thrombosis were detected in the stented MPV.
A liver porcine model was used to demonstrate that the transhepatic placement of a novel endovascular brachytherapy stent, EVB-Stent, is both technically feasible and safe.
碘 - 125（I）籽源链与支架相结合的血管内植入是治疗门静脉肿瘤血栓形成的有效方法。本研究的目的是开发一种新型血管内近距离治疗支架（EVB - 支架）并评估其使用的可行性。
通过经皮经肝途径将EVB - 支架植入活猪模型的主门静脉（MPV）中。在手术前后以及安乐死之前采集血样并进行检测。术后直接进行单光子发射计算机断层扫描（SPECT）与CT（SPECT/CT）联合扫描，并在植入后2个月进行CT扫描。在进行CT扫描后，对所有动物实施安乐死并进行组织学检查。
新型支架在所有6头猪中均成功定位。在2个月的随访期内未观察到肝功能恶化。SPECT/CT显示籽源链周围辐射分布均匀，最热区域靠近MPV中心。通过CT扫描证实了植入支架的MPV通畅。在横向距离I籽源链中点10 mm处，组织累积吸收剂量为31,822.11 mGy，半衰期为59.4天。病理检查结果显示附属肝组织无明显萎缩或炎症，植入支架的MPV未检测到明显的内膜增厚或血栓形成。
使用猪肝模型证明，新型血管内近距离治疗支架EVB - 支架经肝放置在技术上是可行且安全的。
