Andras Konya1, Kenneth C Wright. 1. Department of Diagnostic Radiology, University of Texas M. D. Anderson Cancer Center, Houston 77030, USA. akonya@mdanderson.org
Abstract
RATIONALE AND OBJECTIVES: To evaluate the effect of capillary embolization with superselectively administered 1:1 Ethiodol-ethanol mixture (EEM) for complete nephrectomy in normal porcine kidneys. MATERIALS AND METHODS: One kidney in each animal was completely embolized by sequential segmental arterial injections of the EEM via a microcatheter until complete capillary stasis occurred. Group 1 (n = 5): Initial embolization did not occlude the arterial compartment. Group 2 (n = 7): The capillary embolization was performed in conjunction with absolute ethanol injection and coil placement during balloon catheter occlusion. RESULTS: Group 1: Complete recanalization occurred following the EEM embolization (1-week). After the repeat embolization (EEM + pure ethanol without balloon occlusion), three of five kidneys showed partial recanalization (2-weeks). Following a third embolization (EEM + coil) in two pigs, one kidney showed partial recanalization (12-weeks). Group 2: Complete renal artery occlusion was achieved in all kidneys with no recanalization. Histologically, four kidneys exhibited total ablation whereas three showed minimal preexisting parenchyma (8-weeks). CONCLUSIONS: Permanent arterial occlusion with histologically complete renal ablation was achieved using a two-phase technique of homogeneous capillary embolization with 1:1 EEM and ethanol and coil occlusion performed during temporary balloon occlusion. Sequential segmental EEM injections alone did not produce permanent capillary embolization.
RATIONALE AND OBJECTIVES: To evaluate the effect of capillary embolization with superselectively administered 1:1 Ethiodol-ethanol mixture (EEM) for complete nephrectomy in normal porcine kidneys. MATERIALS AND METHODS: One kidney in each animal was completely embolized by sequential segmental arterial injections of the EEM via a microcatheter until complete capillary stasis occurred. Group 1 (n = 5): Initial embolization did not occlude the arterial compartment. Group 2 (n = 7): The capillary embolization was performed in conjunction with absolute ethanol injection and coil placement during balloon catheter occlusion. RESULTS: Group 1: Complete recanalization occurred following the EEM embolization (1-week). After the repeat embolization (EEM + pure ethanol without balloon occlusion), three of five kidneys showed partial recanalization (2-weeks). Following a third embolization (EEM + coil) in two pigs, one kidney showed partial recanalization (12-weeks). Group 2: Complete renal artery occlusion was achieved in all kidneys with no recanalization. Histologically, four kidneys exhibited total ablation whereas three showed minimal preexisting parenchyma (8-weeks). CONCLUSIONS: Permanent arterial occlusion with histologically complete renal ablation was achieved using a two-phase technique of homogeneous capillary embolization with 1:1 EEM and ethanol and coil occlusion performed during temporary balloon occlusion. Sequential segmental EEM injections alone did not produce permanent capillary embolization.