Division of Interventional Radiology, Department of Radiology, Zucker School of Medicine at Hofstra/Northwell, Manhasset, New York.
Instylla, Bedford, Massachusetts.
J Vasc Interv Radiol. 2022 Jun;33(6):653-659. doi: 10.1016/j.jvir.2022.02.022. Epub 2022 Mar 10.
To evaluate the ability to achieve hemostasis of a new liquid embolic agent in a porcine mesenteric artery hemorrhage model.
An anticoagulated porcine mesenteric artery hemorrhage model was created using a transarterial approach. Arterial hemorrhage was the result of aspiration needle punctures and simultaneous radiofrequency current application. Ten injured mesenteric arteries in 8 swine were treated. The hydrogel liquid embolic agent under investigation, an aqueous-based and in situ polymerizing liquid embolic agent, was used to treat actively bleeding sites. At 7 days, confirmation angiography was performed, followed by necropsy.
The mesenteric arterial injuries produced persistent and angiographically visible hemorrhage before initiating embolic therapy. Arteriovenous fistulae were observed in 4 cases. Embolization led to hemostasis in 10 of the 10 bleeds (100%). The mean embolic agent delivery time was 5.3 minutes (range, 1-15 minutes) with a mean embolic agent volume of 2.9 mL (range, 0.8-5.2 mL) delivered to achieve hemostasis. Notably, 40% of the treatments embolized the injury in the artery at the treatment site while leaving the native arterial lumen patent for the 7-day term of survival. All animals survived with no clinical evidence of hemorrhage through 7 days. Necropsy did not reveal evidence of ischemia within the bowel, liver, or lung.
A new hydrogel liquid embolic agent was found to achieve rapid and durable hemostasis in an animal model of acute mesenteric hemorrhage.
评估一种新型液体栓塞剂在猪肠系膜动脉出血模型中止血能力。
通过经动脉途径创建抗凝猪肠系膜动脉出血模型。动脉出血是抽吸针穿刺和同时应用射频电流的结果。8 头猪的 10 条受伤肠系膜动脉接受治疗。正在研究的水凝胶液体栓塞剂是一种基于水的原位聚合液体栓塞剂，用于治疗正在出血的部位。在第 7 天进行确认性血管造影，然后进行尸检。
在开始栓塞治疗之前，肠系膜动脉损伤导致持续且血管造影可见的出血。4 例观察到动静脉瘘。栓塞治疗导致 10 次出血中的 10 次（100%）止血。平均栓塞剂输送时间为 5.3 分钟（范围，1-15 分钟），平均栓塞剂体积为 2.9 毫升（范围，0.8-5.2 毫升），以实现止血。值得注意的是，40%的治疗在治疗部位栓塞了动脉损伤，同时保留了原生动脉管腔的通畅性，持续到 7 天的存活期。所有动物在 7 天内均存活，无出血的临床证据。尸检未发现肠、肝或肺内缺血的证据。
一种新型水凝胶液体栓塞剂在急性肠系膜出血动物模型中被发现可快速持久地止血。
