Mathieu Di Bisceglie1,2,3, Jean-Francois Hak4,5,6, Abdoulaye Dione Diop7, Gloria Salazar8,9, Pauline Brige5,6, Julien Panneau4,5,6, Farouk Tradi4,5,6,10, Paul Habert4,5,6, Jacques-Yves Campion6, Abdoulaye Ndoye Diop11, Gilles Soulez10, Benjamin Guillet6,12,13, Vincent Vidal4,5,6. 1. Interventional Radiololy Section, Department of Medical Imaging, University Hospital Timone, APHM, Marseille, France. Mathieu.di-bisceglie@ap-hm.fr. 2. LiiE, Aix Marseille University, Marseille, France. Mathieu.di-bisceglie@ap-hm.fr. 3. CERIMED, Aix Marseille University, 27 Bd Jean Moulin 13005, Marseille, France. Mathieu.di-bisceglie@ap-hm.fr. 4. Interventional Radiololy Section, Department of Medical Imaging, University Hospital Timone, APHM, Marseille, France. 5. LiiE, Aix Marseille University, Marseille, France. 6. CERIMED, Aix Marseille University, 27 Bd Jean Moulin 13005, Marseille, France. 7. Diagnostic and Medical Imaging Center, Fann National University Hospital Center, 5035, Dakar, Senegal. 8. Division of Interventional Radiology, Massachusetts General Hospital, Boston, MA, USA. 9. Harvard Medical School, Boston, MA, USA. 10. Department of Radiology, University Hospital Center of Montreal, Montreal, Canada. 11. UFR 2S, Gaston Berger University, BP234, Saint Louis, Senegal. 12. INSERM1263, INRA 1260, C2VN, Aix Marseille University, Marseille, France. 13. Department of Radiopharmacy, APHM, Marseille, France.
Abstract
PURPOSE: Microspheres are effective embolic agents, especially for the management of bleeding and oncologic lesions. The first FairEmbo study reported the effectiveness of embolization using suture fragments. The effectiveness and safety of arterial embolization with suture-based microparticles (SBM) were assessed in a swine model. MATERIALS AND METHODS: In this ethical-approved animal study, a polar artery in each kidney was embolized in four swine: one side with hand-cut non-absorbable SBM (Flexocrin 2®) and the contralateral side with Embozene® 900 for comparison. Swine were followed for 3 months (M3) to evaluate the effectiveness and the safety of SBM. Follow-up protocol included clinical monitoring, computed tomography (CT) control and digital subtraction angiography (DSA), followed by histological analyses. The SBM confection parameters were evaluated by automatic microscopic sizer. RStudio software and Mann-Whitney test (significance at P < 0.05) were used for statistics. RESULTS: The average size of SBM was 1002 μm (SD = 258). All targets were effectively embolized by SBM with an angiogram defect estimated at 45.6% (95% CI [35.9-55.2]), compared to 40.5% (95% CI [30.6-55.5]) for Embozene® group (P = 0.342). The average duration of SBM embolization procedure was significantly increased compared to Embozene® embolization (1202 s versus 222 s, P = 0.029). There were no statistical differences in M3 DSA and CT for SBM and Embozene®, with persistence of partial arterial occlusion and atrophic embolized area. No postoperative complications were observed on clinical and CT controls. CONCLUSION: This experimental study suggests that embolization with SBM is feasible, safe and effective in short- and medium-term follow-up as compared to microspheres.
PURPOSE: Microspheres are effective embolic agents, especially for the management of bleeding and oncologic lesions. The first FairEmbo study reported the effectiveness of embolization using suture fragments. The effectiveness and safety of arterial embolization with suture-based microparticles (SBM) were assessed in a swine model. MATERIALS AND METHODS: In this ethical-approved animal study, a polar artery in each kidney was embolized in four swine: one side with hand-cut non-absorbable SBM (Flexocrin 2®) and the contralateral side with Embozene® 900 for comparison. Swine were followed for 3 months (M3) to evaluate the effectiveness and the safety of SBM. Follow-up protocol included clinical monitoring, computed tomography (CT) control and digital subtraction angiography (DSA), followed by histological analyses. The SBM confection parameters were evaluated by automatic microscopic sizer. RStudio software and Mann-Whitney test (significance at P < 0.05) were used for statistics. RESULTS: The average size of SBM was 1002 μm (SD = 258). All targets were effectively embolized by SBM with an angiogram defect estimated at 45.6% (95% CI [35.9-55.2]), compared to 40.5% (95% CI [30.6-55.5]) for Embozene® group (P = 0.342). The average duration of SBM embolization procedure was significantly increased compared to Embozene® embolization (1202 s versus 222 s, P = 0.029). There were no statistical differences in M3 DSA and CT for SBM and Embozene®, with persistence of partial arterial occlusion and atrophic embolized area. No postoperative complications were observed on clinical and CT controls. CONCLUSION: This experimental study suggests that embolization with SBM is feasible, safe and effective in short- and medium-term follow-up as compared to microspheres.
Authors: A Chatziioannou; D Gargas; K Malagari; I Kornezos; I Ioannidis; E Primetis; H Moschouris; A Gouliamos; D Mourikis Journal: Eur J Radiol Date: 2011-06-25 Impact factor: 3.528
Authors: D P Link; J D Strandberg; R Virmani; K Blashka; F Mourtada; M A Samphilipo Journal: J Vasc Interv Radiol Date: 1996 Nov-Dec Impact factor: 3.464
Authors: V Vidal; J F Hak; P Brige; S Chopinet; F Tradi; M Bobot; P Gach; A Haffner; G Soulez; A Jacquier; G Moulin; J M Bartoli; B Guillet Journal: Cardiovasc Intervent Radiol Date: 2019-04-11 Impact factor: 2.740