Stewart Jessica K, Hipolito Canario Diego A, Daso Gabrielle, Thapa Diwash, Montgomery Stephanie, Kohi Maureen
Division of Interventional Radiology, Department of Radiological Sciences, David Geffen School of Medicine at UCLA, Los Angeles, California.
Department of Radiology, University of North Carolina School of Medicine, Chapel Hill, North Carolina.
J Vasc Interv Radiol. 2023 Feb;34(2):225-233. doi: 10.1016/j.jvir.2022.10.026. Epub 2022 Oct 25.
To determine whether fallopian tube embolization with n-butyl-2-cyanoacrylate (nBCA) administered via a microcatheter in a rabbit model was technically feasible and resulted in short-term tubal occlusion.
In 10 female New Zealand white rabbits, the 2 cervices were cannulated using a 5-F catheter and hydrophilic guide wire transvaginally. Salpingography confirmed tubal patency bilaterally. A 2.4-F microcatheter was advanced to the distal fallopian tube, and nBCA/ethiodized oil was administered as the microcatheter was withdrawn to fill the length of the tube. A metallic coil was deployed prior to nBCA administration in half of the fallopian tubes. Rabbits were evaluated for tubal occlusion with salpingography at 1 month, followed by euthanasia and histopathologic analysis. Inflammation and fibrosis were graded from 0 (normal) to 3 (severe).
Fallopian tube embolization was technically successful in 17 (85%) of 20 fallopian tubes. Thirteen (76%) of 17 embolized fallopian tubes were occluded at 1 month on salpingography (nBCA only, 7/9; nBCA and coil, 6/8). On histopathologic analysis, direct or indirect evidence of occlusion was observed in 14 (82%) of 17 fallopian tubes. Mild or early fibrosis was observed in 65% of the tubes. The mean inflammation and fibrosis scores for the embolized tubes were 0.62 and 0.94, respectively.
This pilot study demonstrated that embolization of rabbit fallopian tubes using nBCA administered via a microcatheter is technically feasible and results in occlusion of most fallopian tubes in the short term with minimal inflammation. Investigation of efficacy in preventing pregnancy over the long term is warranted.
确定在兔模型中经微导管注入正丁基-2-氰基丙烯酸酯(nBCA)进行输卵管栓塞在技术上是否可行,并导致短期输卵管闭塞。
对10只雌性新西兰白兔,经阴道使用5F导管和亲水性导丝分别插入双侧宫颈。输卵管造影证实双侧输卵管通畅。将一根2.4F微导管推进至输卵管远端,在回撤微导管时注入nBCA/碘化油以填充输卵管全长。在一半的输卵管中,在注入nBCA之前先放置一个金属线圈。在1个月时对兔子进行输卵管造影评估输卵管闭塞情况,随后实施安乐死并进行组织病理学分析。炎症和纤维化程度从0(正常)到3(严重)进行分级。
20条输卵管中有17条(85%)在技术上成功进行了输卵管栓塞。在1个月时,17条栓塞的输卵管中有13条(76%)在输卵管造影中显示闭塞(仅nBCA组,7/9;nBCA加线圈组,6/8)。组织病理学分析显示,17条输卵管中有14条(82%)有直接或间接的闭塞证据。65%的输卵管观察到轻度或早期纤维化。栓塞输卵管的平均炎症和纤维化评分分别为0.62和0.94。
这项初步研究表明,经微导管注入nBCA对兔输卵管进行栓塞在技术上是可行的,并且在短期内可使大多数输卵管闭塞,炎症轻微。有必要对其长期预防妊娠的疗效进行研究。