Treatment of Acute Hemoptysis by Bronchial Artery Embolization with the Liquid Embolic Agent Ethylene Vinyl Alcohol Copolymer

PurposeTo determine the technical and clinical success of bronchial artery embolization (BAE) with the liquid embolic agent ethylene vinyl alcohol (EVOH) copolymer in patients with acute hemoptysis.Materials and MethodsThirty-four patients (25 male; mean age, 58 y; range, 13–78 y) who underwent BAE with EVOH were retrospectively reviewed. Reasons for acute hemoptysis included lung cancer (44%), pulmonary metastases (12%), bronchiectasis (21%), arteriovenous malformation (5%), tuberculosis (6%), aspergilloma (3%), acute respiratory distress syndrome (3%), anticoagulant overdose (3%), and scar tissue (3%). Technical and clinical success of BAE were retrospectively assessed.ResultsEmbolization was technically successful in 94% of patients. Additional embolization material was needed in 4 patients (12%). The immediate clinical success rate was 94% (32 of 34); in 2 patients (6%), hemoptysis recurred immediately after the intervention or could not be stopped. Periinterventional minor complications included headache (n = 1), fever (n = 1), and acute renal failure (n = 1). During follow-up (mean, 8.8 mo), 5 patients had a recurrence of hemoptysis (15%).ConclusionsThe use of EVOH copolymer for BAE in patients with acute hemoptysis is technically successful and safe and has a good clinical outcome with a low number of recurrences.     

热塑性淀粉/乙烯-乙烯醇共聚物复合材料的制备与性能

利用熔融共混的方法,制备得到热塑性淀粉/乙烯-乙烯醇共聚物（TPS/EVOH）复合材料,并对该复合体系的加工性能、机械性能、动态力学性能、流变性能以及吸水性进行了研究.结果表明：随着EVOH含量增加,复合材料中分子间作用力加强;复合体系的机械性能得到改善;当EVOH含量到达30%后,复合材料的吸水性明显降低.     

Morphology Prediction in HDPE/PA‐6/EVOH Ternary Blends: Defining the Role of Elasticity Ratio

The morphology of uncompatibilized HDPE/PA‐6/EVOH ternary blends was predicted using static and dynamic phenomenological models wherein PA‐6 to EVOH component ratio and temperature were chosen as influential parameters. The type of morphology and particle size in HDPE/PA‐6/EVOH blends are then examined by scanning electron microscopy and image analysis techniques. The core–shell structure was observed for all ternary samples, in which PA‐6 domains were encapsulated by a thin layer of EVOH within HDPE matrix. Among various criteria, that is, viscosity ratio, interfacial tension, and elasticity ratio, the elasticity ratio has been found to be the most influential parameter for investigation of core–shell size alteration with temperature and component ratio.     

Transrenal Ureteral Occlusion for Palliation of Refractory Urine Leaks Using Vascular Plugs and Liquid Ethylene Vinyl Alcohol

PurposeTo describe outcomes of transrenal embolization with vascular plugs and ethylene vinyl alcohol (EVOH) in a case series of patients with refractory urinary leak or fistula.Materials and MethodsFifteen ureteral occlusions performed over 53 months in 9 consecutive patients (56% female; mean age 61 y; range, 45–80 y) were reviewed retrospectively. The main indication was palliation for refractory fistula or leak in the setting of malignancy not responding to urine diversion by percutaneous nephrostomy tube or nephroureteral stent. Transrenal ureteral occlusion was performed using EVOH injected between vascular plugs placed distal and proximal to the leak or fistula.ResultsTechnical success was 100%. Considerable reduction of urine leak or symptoms (clinical success) was achieved in 64% of ureters after mean follow-up of 105 days (range, 0–632 d). Complete ureteral occlusion on follow-up anterograde nephrostogram (imaging success) was achieved in 60% of ureters after mean follow-up of 139 days (range, 0–643 d). One patient with distal ureterovesical junction–perineal fistula had continued leak despite complete proximal occlusion of ureter owing to retrograde urine reflux from the bladder and was treated with endoscopic injection of intramural calcium hydroxyapatite to the ureteral segment distal to the fistula. Three ureters (33%) in 2 patients with vesicovaginal fistula had recanalization, requiring additional proximal embolization, yielding secondary success rates of 91% (clinical) and 90% (imaging) per ureter. One minor urinary tract infection and no major complications occurred.ConclusionsTransrenal anterograde ureteral occlusion using EVOH between vascular plugs could be considered a relatively safe and potentially valuable treatment option for refractory ureteral fistulae.     

Ethylene vinyl alcohol copolymer (Onyx®) in peripheral interventional radiology: Indications,advantages and limitations

Onyx^® is a remarkable liquid embolizing agent that may allow a well-trained operator to undertake challenging embolization procedures. In multiple interventional radiology indications, the physico-chemical properties of Onyx^® allow safe embolization. The purpose of this article is to review the advantages and disadvantages of Onyx^® and identify its main indications.     

Elective and Emergency Renal Angiomyolipoma Embolization with Ethylene Vinyl Alcohol Copolymer: Feasibility and Initial Experience

Purpose

To report preliminary experience with angiomyolipoma (AML) transcatheter arterial embolization using ethylene vinyl alcohol (EVOH) copolymer liquid embolic agent.