Zhou Hongfu, Xie Wenjing, Guo Anran, Chen Bin, Hu Sanming, Zheng Min, Yu Houqiang, Tian Hongan, Li Ling
School of Biomedical Engineering and Imaging, Xianning Medical College, Hubei University of Science and Technology, Xianning, PR China.
School of Pharmacy, Xianning Medical College, Hubei University of Science and Technology, Xianning, PR China.
Des Monomers Polym. 2023 Jan 18;26(1):31-44. doi: 10.1080/15685551.2022.2164445. eCollection 2023.
Several vascular embolization materials are commonly used in clinical practice, however, having application defects of varying degrees, such as poor intraoperative imaging and easy recanalization of embolized blood vessels, they are challenging for application during Transcatheter arterial embolization (TAE). Thus, an intraoperative visible vascular embolization material with good embolization effect and biocompatibility can improve transcatheter arterial embolization clinical efficacy to some extent. Our study aimed to synthesize a novel vascular embolization material that can achieve complete embolization of arterial trunks and peripheral vessels, namely poly (N-isopropyl acrylamide)--acrylic acid nanogel (NIPAM--AA). Iohexol 200 mg/mL was co-assembled with 7 wt% NIPAM--AA nanogel to create an intelligent thermosensitive radiopaque nanogel (INCA), which achieves a good intraoperative imaging effect and is convenient for transcatheter arterial bolus injection due to its good fluidity and temperature-sensitive sol-gel phase transition. The normal rabbit kidney embolism model further confirmed that INCA could effectively use Digital subtraction angiography (DSA) to achieve intraoperative imaging, and real-time monitoring of the embolization process could avoid mis-embolization and leakage. Meanwhile, in a 42-day study, INCA demonstrated an excellent embolization effect on the right renal artery of New Zealand white rabbits, with no vascular recanalization and ischemic necrosis and calcification remaining. As a result, this radiopaque thermosensitive nanogel has the potential to be an intelligent thermosensitive medical vascular embolization material, providing dual benefits in TAE intraoperative imaging and long-term postoperative embolization while effectively addressing the shortcomings and challenges of commonly used clinical vascular embolization agents.
临床实践中常用几种血管栓塞材料,然而,它们存在不同程度的应用缺陷,如术中成像不佳和栓塞血管易再通,在经导管动脉栓塞术(TAE)中应用具有挑战性。因此,一种术中可见、栓塞效果良好且生物相容性好的血管栓塞材料可在一定程度上提高经导管动脉栓塞术的临床疗效。我们的研究旨在合成一种新型血管栓塞材料,即聚(N-异丙基丙烯酰胺)-丙烯酸纳米凝胶(NIPAM-AA),它能够实现动脉主干和外周血管的完全栓塞。将200mg/mL的碘海醇与7wt%的NIPAM-AA纳米凝胶共组装,制成一种智能热敏性显影纳米凝胶(INCA),其具有良好的术中成像效果,且由于流动性好和温度敏感的溶胶-凝胶相变,便于经导管动脉推注。正常兔肾栓塞模型进一步证实,INCA能有效利用数字减影血管造影(DSA)实现术中成像,实时监测栓塞过程可避免误栓塞和渗漏。同时,在一项为期42天的研究中,INCA对新西兰白兔右肾动脉显示出优异的栓塞效果,无血管再通,且无缺血坏死和钙化残留。因此,这种显影热敏纳米凝胶有潜力成为一种智能热敏性医用血管栓塞材料,在TAE术中成像和术后长期栓塞方面提供双重益处,同时有效解决临床常用血管栓塞剂的缺点和挑战。