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Reduced nontarget embolization and increased targeted delivery with a reflux-control microcatheter in a swine model
Abstract:PurposeTo evaluate the potential differences in non-target embolization and vessel microsphere filling of a reflux-control microcatheter (RCM) compared to a standard end-hole microcatheter (SEHM) in a swine model.Materials and methodsRadiopaque microspheres were injected with both RCM and SEHM (2.4-Fr and 2.7-Fr) in the kidneys of a preclinical swine model. Transarterial renal embolization procedures with RCM or SEHM were performed in both kidneys of 14 pigs. Renal arteries were selectively embolized with an automated injection protocol of radio-opaque microspheres. Ex-vivo X-ray microtomography images of the kidneys were utilized to evaluate the embolization by quantification of the deposition of injected microspheres in the target vs. the non-target area of injection. X-ray microtomography images were blindly analyzed by five interventional radiologists. The degree of vessel filling and the non-target embolization were quantified using a scale from 1 to 5 for each parameter. An analysis of variance was used to compare the paired scores.ResultsTotal volumes of radio-opaque microspheres injected were similar for RCM (11.5 ± 3.6 SD] mL; range: 6–17 mL) and SEHM (10.6 ± 5.2 SD] mL; range: 4–19 mL) (P = 0.38). The voxels enhanced ratio in the target (T) vs. non-target (NT) areas was greater with RCM (T = 98.3% vs. NT = 1.7%) than with SEHM (T = 89% vs. NT = 11%) but the difference was not significant (P = 0.30). The total score blindly given by the five interventional radiologists was significantly different between RCM (12.3 ± 2.1 SD]; range: 6–15) and the standard catheter (11.3 ± 2.5 SD]; range: 4–15) (P = 0.0073), with a significant decrease of non-target embolization for RCM (3.8 ± 1.3 SD]; range: 3.5–4.2) compared to SEHM (3.2 ± 1.5 SD]; range: 2.9–3.5) (P = 0.014).ConclusionIn an animal model, RCM microcatheters reduce the risk of non-target embolization from 11% to 1.7%, increasing the delivery of microspheres of 98% to the target vessels, compared to SEHM microcatheters.
Keywords:Embolization  Therapeutic  Interventional radiology  Non-target embolization  X-ray microtomography  Preclinical evaluation  CI"}  {"#name":"keyword"  "$":{"id":"kw0040"}  "$$":[{"#name":"text"  "_":"Confidence interval  LS means"}  {"#name":"keyword"  "$":{"id":"kw0050"}  "$$":[{"#name":"text"  "_":"Least-squares means  μCT"}  {"#name":"keyword"  "$":{"id":"kw0060"}  "$$":[{"#name":"text"  "_":"X-ray microtomography  NTE"}  {"#name":"keyword"  "$":{"id":"kw0070"}  "$$":[{"#name":"text"  "_":"Non-target embolization  RCM"}  {"#name":"keyword"  "$":{"id":"kw0080"}  "$$":[{"#name":"text"  "_":"Reflux-control micro-catheter  SEHM"}  {"#name":"keyword"  "$":{"id":"kw0090"}  "$$":[{"#name":"text"  "_":"Standard end-hole micro-catheter  SD"}  {"#name":"keyword"  "$":{"id":"kw0100"}  "$$":[{"#name":"text"  "_":"Standard deviation  TACE"}  {"#name":"keyword"  "$":{"id":"kw0110"}  "$$":[{"#name":"text"  "_":"Transcatheter arterial chemoembolization
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