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CardioVascular and Interventional Radiology
Published in: CardioVascular and Interventional Radiology 6/2019

01-06-2019 | Magnetic Resonance Imaging | Laboratory Investigation

The Novel X-Ray Visible Zein-Based Non-adhesive Precipitating Liquid Embolic HEIE1_2017: An Exploratory Study

Authors: Dominik F. Vollherbst, Thuy D. Do, Manfred Jugold, Viktoria Eichwald, Stephan Macher-Göppinger, Philippe L. Pereira, Martin Bendszus, Markus A. Möhlenbruch, Götz M. Richter, Hans U. Kauczor, Christof M. Sommer

Published in: CardioVascular and Interventional Radiology | Issue 6/2019

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Abstract

Purpose

To investigate the novel zein-based non-adhesive precipitating liquid embolic HEIE1_2017.

Materials and Methods

Zein-based liquid embolics are an own class of embolization material. In this study, HEIE1_2017, a novel zein-based liquid embolic, was investigated. Visibility was assessed in vitro in CT and MRI phantoms, embolization characteristics were assessed in vivo in the kidneys of 12 pigs. Components of HEIE1_2017 were zein as occlusion material, ethanol as solvent, and iodized oil as radiopaque material. HEIE1_2017 was used in pure (HEI-PURE) and manually modified (HEI-MOD) form and compared with 6% ethylene vinyl alcohol copolymer (EVOH). Different radiological methods (CT, MRI, DSA, cone-beam CT, and micro-CT) and histopathologic analyses were applied to compare visibility and vascular occlusion patterns.

Results

In CT phantoms, all embolics were definitely visible as hyperdense materials. In MRI phantoms, signal-to-noise ratio was highest for HEI-PURE, followed by HEI-MOD and EVOH. In all kidneys, embolization procedures were technically successful and without complications. In DSA, all embolics were definitely visible during and after embolization. Only EVOH caused substantial artifacts in cone-beam CT and CT. In micro-CT and histopathology, HEI-PURE showed a homogeneous occlusion from segmental arteries to glomerular capillaries. HEI-MOD demonstrated the deepest vascular penetration (up to the level of peritubular capillaries), but with an inhomogeneous distribution. For EVOH, there was inhomogeneous vascular occlusion from segmental arteries to glomerular capillaries.

Conclusion

HEIE1_2017 is a promising novel zein-based liquid embolic. Further preclinical and clinical studies with higher case numbers and long-term follow-up are needed to further assess the value of this embolic material.
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Metadata
Title
The Novel X-Ray Visible Zein-Based Non-adhesive Precipitating Liquid Embolic HEIE1_2017: An Exploratory Study
Authors
Dominik F. Vollherbst
Thuy D. Do
Manfred Jugold
Viktoria Eichwald
Stephan Macher-Göppinger
Philippe L. Pereira
Martin Bendszus
Markus A. Möhlenbruch
Götz M. Richter
Hans U. Kauczor
Christof M. Sommer
Publication date
01-06-2019
Publisher
Springer US
Published in
CardioVascular and Interventional Radiology / Issue 6/2019
Print ISSN: 0174-1551
Electronic ISSN: 1432-086X
DOI
https://doi.org/10.1007/s00270-019-02179-9

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