Embolization of experimental wide-necked aneurysms with iodine-containing polyvinyl alcohol solubilized in a low-angiotoxicity solvent

Dudeck, O; Jordan, O; Hoffmann, KT; Okuducu, AF; Husmann, I; Kreuzer-Nagy, T; Tesmer, K; Podrabsky, P; Bruhn, H; Hilborn, J; Rüfenacht, DA; Doelker, E; Felix, R

HERO ID

3539775

Reference Type

Journal Article

Year

2006

Language

English

PMID

17032855

HERO ID 3539775
In Press No
Year 2006
Title Embolization of experimental wide-necked aneurysms with iodine-containing polyvinyl alcohol solubilized in a low-angiotoxicity solvent
Authors Dudeck, O; Jordan, O; Hoffmann, KT; Okuducu, AF; Husmann, I; Kreuzer-Nagy, T; Tesmer, K; Podrabsky, P; Bruhn, H; Hilborn, J; Rüfenacht, DA; Doelker, E; Felix, R
Journal American Journal of Neuroradiology
Volume 27
Issue 9
Page Numbers 1849-1855
Abstract <strong>BACKGROUND AND PURPOSE: </strong>To evaluate the ready-to-use iodine-containing polyvinyl alcohol (I-PVA) dissolved in the low angiotoxic solvent N-methyl pyrrolidone (NMP) for embolization of porcine wide-necked aneurysms.<br /><br /><strong>METHODS: </strong>Fourteen broad-based carotid sidewall aneurysms were surgically constructed in 7 swine. I-PVA (40%) in NMP was injected under temporary balloon occlusion bridging the aneurysm neck. After 4 weeks, follow-up angiography, multisection CT angiography (MSCTA), and 3T MR imaging including MR angiography (MRA) sequences were performed. Afterward, harvested aneurysms were investigated histopathologically.<br /><br /><strong>RESULTS: </strong>The liquid embolic was well visible under fluoroscopy and displayed a favorable precipitation pattern, allowing for controlled polymer delivery. Ten aneurysms (71%) were initially completely occluded, whereas in 1 aneurysm, a minimal polymer leakage was observed. The other 4 aneurysms (29%) were almost completely occluded. One animal suffered a lethal rebleeding from the anastomosis after uneventful embolization. Aneurysms embolized with I-PVA could be discriminated well from the parent artery without beam-hardening artifacts on MSCTA, and no susceptibility artifacts were encountered on MR imaging. Histologic examination revealed all aneurysms covered with a membrane of fibroblasts and an endothelial cell layer while a moderate intraaneurysmal inflammatory response to the polymer was observed.<br /><br /><strong>CONCLUSION: </strong>I-PVA dissolved in NMP has proved its effectiveness for the embolization of experimental wide-necked aneurysms. This precipitating liquid embolic offers several interesting features in that it needs no preparation before use and no radiopaque admixtures, the latter allowing for artifact-free evaluation of treated aneurysms with MSCTA and MRA. Moreover, it uses NMP as a solvent, which has only a low angiotoxicity.
Pmid 17032855
Wosid WOS:000241316400015
Is Certified Translation No
Dupe Override No
Is Public Yes
Language Text English