一种新型温度依赖性液态血管内栓塞材料——温热流变液的初步动物研究。
A preliminary animal study of thermal rheology fluid as a new temperature-dependent liquid intravascular embolic material.
机构信息
Department of Radiology, Shiga University of Medical Science, Seta Tsukinowa-Cho, Otsu, Shiga, 520-2192, Japan.
Department of Radiology, National Hospital Organization, Higashi-Ohmi General Medical Center, Higashiomi, Shiga, Japan.
出版信息
Jpn J Radiol. 2022 Jun;40(6):613-623. doi: 10.1007/s11604-021-01232-3. Epub 2021 Dec 1.
PURPOSE
Thermal rheology (TR) fluid, which comprises polyethylene (PE) particles, their dispersant, and solvent, is a material that increases in viscosity to various degrees depending on the type and ratio of these constituents when its temperature rises. The viscosity of type 1 (TRF-1) increases more than that of type 2 (TRF-2) near rabbit body temperature. This preliminary animal study aimed to determine the basic characteristics and embolic effect of TR fluid by comparing TRF-1 and TRF-2.
MATERIALS AND METHODS
Twenty-four Japanese white rabbits underwent unilateral renal artery embolization using TRF-1 or TRF-2 and follow-up angiography at 7 or 28 days (4 subgroups, n = 6 each). Subsequently, the rabbits were euthanized, and the embolized kidneys were removed for pathological examination. The primary and final embolization rates were defined as the ratio of renal artery area not visible immediately after embolization and follow-up angiography, respectively, to visualized renal artery area before embolization. The final embolization rate and maximum vessel diameter filled with PE particles were compared between materials. Moreover, the embolic effect was determined to be persistent when a two-sided 95% confidence interval (CI) for the difference in means between the embolization rates was < 5%.
RESULTS
The final embolization rate was significantly higher for the TRF-1 than for the TRF-2 at both 7 (mean 80.7% [SD 18.7] vs. 28.4% [19.9], p = 0.001) and 28 days (94.0% [3.5] vs. 37.8% [15.5], p < 0.001). The maximum occluded vessel diameter was significantly larger for TRF-1 than for TRF-2 (870 µm [417] vs. 270 µm [163], p < 0.001). The embolic effect of TRF-1 was persistent until 28 days (difference between rates - 3.3 [95% CI - 10.0-3.4]).
CONCLUSION
The embolic effect of TRF-1 was more persistent than that of TRF-2, and the persistency depended on the type and ratio of TR fluid constituents.
目的
热流变性（TR）流体由聚乙烯（PE）颗粒、其分散剂和溶剂组成，当温度升高时，其粘度会根据这些成分的类型和比例而不同程度地增加。1 型（TRF-1）的粘度比 2 型（TRF-2）在接近兔体温时增加得更多。本初步动物研究旨在通过比较 TRF-1 和 TRF-2 来确定 TR 流体的基本特性和栓塞效果。
材料和方法
24 只日本大白兔采用 TRF-1 或 TRF-2 进行单侧肾动脉栓塞，7 或 28 天后进行随访血管造影（4 个亚组，每组 6 只）。随后处死兔子，取出栓塞的肾脏进行病理检查。主要栓塞率和最终栓塞率分别定义为栓塞后即刻和随访血管造影时肾动脉未见面积与栓塞前可见肾动脉面积的比值。比较两种材料的最终栓塞率和填充 PE 颗粒的最大血管直径。此外，当双侧 95%置信区间（CI）的差异在栓塞率之间小于 5%时，栓塞效果被确定为持续。
结果
在 7 天（平均 80.7%[18.7]比 28.4%[19.9]，p=0.001）和 28 天（平均 94.0%[3.5]比 37.8%[15.5]，p<0.001）时，TRF-1 的最终栓塞率明显高于 TRF-2。TRF-1 的最大闭塞血管直径明显大于 TRF-2（870µm[417]比 270µm[163]，p<0.001）。TRF-1 的栓塞效果持续到 28 天（率差-3.3[95%CI-10.0-3.4]）。
结论
TRF-1 的栓塞效果比 TRF-2 更持久，其持久性取决于 TR 流体成分的类型和比例。
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