Histopathologic appearance of arterial occlusions with hydrogel and polyvinyl alcohol embolic material in domestic swine.

PURPOSE: This study observes the histologic changes resulting from a hydrogel embolic agent (polyacrylonitrile [PAN]) compared with polyvinyl alcohol particles (PVA) of similar size. MATERIALS AND METHODS: Hepatic and renal embolizations were performed in 13 domestic swine by selecting small (1-mm) branches utilizing a coaxial 3-F microcatheter. The hydrogel embolic agent (tantalum-loaded and plain) and PVA were delivered through microcatheters. The longest follow-up period was 8 weeks. Postmortem examination of the embolized tissues included gross examination and histologic analysis. RESULTS: Tantalum-loaded PAN particles were radiopaque and seen in groups fluoroscopically and individually with specimen radiography. Histologic studies showed similar luminal and cellular response to PVA and the hydrogel embolic agents. The arterial lesion induced by the hydrogel embolic agents led to an absence of the arterial wall locally in the area of deployment. Hydrogel embolic particles became surrounded in fibrous connective tissue with no arterial wall. PVA and porous hydrogel capsules produced an inflammatory response, resulting in less wall reorganization, and surrounding fibrous connective tissue at 8 weeks than the solid PAN particles. CONCLUSION: These hydrogel embolic create a permanent arterial occlusion by transmural arterial damage. Mechanical effects and, to a lesser degree, inflammatory changes are responsible.

Hydrogel embolic agents. Theory and practice of adding radio-opacity.

RATIONALE AND OBJECTIVES: Spheres of hydrogel have been developed as embolic material with the ability to incorporate radio-opaque materials. To optimize particle design for radiographic or fluoroscopic visualization, we have examined the theoretical determinants of particle contrast. In addition, loaded hydrogel particles were tested in a rabbit model. METHODS: Computer simulations of particle subject contrast were examined regarding particle composition, particle size, patient thickness, and x-ray beam kilovoltage. Embolizations in the rabbit kidney were used to test the practical aspects of the materials. RESULTS: Tantalum and tungsten offer some theoretical and practical advantages over other materials. With this particular hydrogel preparation, contrast material loading was limited to 20% of the volume as loaded contrast agent. The soft particles passed through catheters as small as 3 French; they were usually injected as a suspension of saline/contrast material. Tantalum/hydrogel particles as large as 2 mm could be forced through the 140 cm/3-Fr catheter with a guide wire. CONCLUSIONS: Radio-opacity of embolic material should add an element of control in embolization procedures that is lacking with the current agents. The heavy metals, tungsten and tantalum, are suitable additives for radiopaque material for hydrogel emboli. The input relationship appears predictable with computer monitoring techniques. Initial results in a study of these radiopaque particles are very encouraging. Further studies are underway to evaluate the long-term effects in renal and hepatic circulations.

Experimental renal embolization: preliminary results with polyacrylonitrile-based multiblock copolymers.

Preparations of polyacrylonitrile (PAN) are now being considered as possible new therapeutic embolization agents. This study evaluated two different liquid PAN formulations and a solid particle form (particle diameters, 100-400 microns). Eighteen rabbits underwent unilateral renal embolization with one of the three different preparations (n = 6 in each group). PAN was effective in causing infarcts in all embolized kidneys, which were documented with both angiograms and pathologic findings. These preliminary results show that PAN may have promise as an effective agent for clinical renal embolizations.