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European Radiology

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01-03-2017 | Interventional

A novel, non-adhesive, precipitating liquid embolic implant with intrinsic radiopacity: feasibility and safety animal study

Authors: Zsolt Kulcsár, Agnieszka Karol, Peter W. Kronen, Pfundstein Svende, Karina Klein, Olivier Jordan, Isabel Wanke

Published in: European Radiology | Issue 3/2017

Abstract

Objectives

To evaluate a novel, ready-to-use, iodinated polyvinyl alcohol polymer embolic implant.

Methods

Under good laboratory practice conditions, 26 pigs were investigated. A complex arteriovenous malformation (AVM) model was created in 16 animals, and a simple rete model was used in the remaining 10 animals. The novel material was used for embolization in 22 animals, and a commercially available liquid embolic material in 4 animals as a control group. Animals were killed at 2 days, 3 months and 6 months. Feasibility, efficacy and safety were evaluated radiologically, clinically and histologically.

Results

Preparation was easy, without risk of catheter clogging or adhesiveness. Embolic delivery was well controlled under subtracted fluoroscopy. Visibility was homogeneous throughout the injection and the material behaved cohesively upon delivery. Best lesion penetration was obtained with the use of proximal microballoon occlusion. Unforeseen over-dilution of the test material by DMSO prefilled in the microballoon hub changed the material properties and caused inadvertent cerebral embolization leading to death in five animals. This phenomenon was avoided by practical measures. The casts produced no beam-hardening artefacts on CT scans. Histology showed excellent biocompatibility.

Conclusions

Embolization with this novel, iodinated, precipitating polymer was feasible and effective. Care should be taken during delivery to avoid over-dilution of the material by prefilled DMSO. The material is promising for embolization of AVMs and hypervascular lesions.

Key Points

• The intrinsically opaque precipitating polymer has adequate fluoroscopic visibility

• The polymer does not induce shading or beam-hardening artefacts on CT

• The novel liquid embolic material does not require lengthy preparation

• Lack of implant adherence reduces the risk of entrapment of the delivery catheter

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Title: A novel, non-adhesive, precipitating liquid embolic implant with intrinsic radiopacity: feasibility and safety animal study
Authors: Zsolt Kulcsár
Agnieszka Karol
Peter W. Kronen
Pfundstein Svende
Karina Klein
Olivier Jordan
Isabel Wanke
Publication date: 01-03-2017
Publisher: Springer Berlin Heidelberg
Published in: European Radiology / Issue 3/2017
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-016-4463-7

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

A novel, non-adhesive, precipitating liquid embolic implant with intrinsic radiopacity: feasibility and safety animal study

Abstract

Objectives

Methods

Results

Conclusions

Key Points

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Objectives

Methods

Results

Conclusions

Key Points

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