Temporary Arterial Embolization of Liver Parenchyma with Degradable Starch Microspheres (EmboCept®S) in a Swine Model

• Published in: Cardiovascular and interventional radiology 2015-04, Vol.38 (2), p.435-441
• Main Authors: Pieper, Claus C., Meyer, Carsten, Vollmar, Brigitte, Hauenstein, Karlheinz, Schild, Hans H., Wilhelm, Kai E.
• Format: Article
• Language: English
• Subjects: ANIMAL TISSUES; Animals; APOPTOSIS; Arterial Occlusive Diseases - therapy; ARTERIES; BIOMEDICAL RADIOGRAPHY; BLOOD FLOW; Cardiology; DAMAGE; Disease Models, Animal; DNA; Embolization, Therapeutic - methods; EOSIN; HEMATOXYLIN; Hepatic Artery - diagnostic imaging; Imaging; LABELLING; Laboratory Investigation; LIVER; Liver - blood supply; Liver - diagnostic imaging; LIVER CELLS; Medicine; Medicine & Public Health; MICROSPHERES; Nuclear Medicine; PLANT TISSUES; Radiography; Radiology; RADIOLOGY AND NUCLEAR MEDICINE; STARCH; Starch - administration & dosage; Starch - therapeutic use; SWINE; Treatment Outcome; Ultrasound; VASCULAR DISEASES
• ISSN: 0174-1551; 1432-086X
• DOI: 10.1007/s00270-014-0966-2

Background This study aimed to evaluate the embolic properties, time to reperfusion, and histologic changes in temporary embolization of liver tissue with degradable starch microspheres (DSM) in a swine model. Methods In four adult minipigs, DSMs were injected into the right or left hepatic artery on the lobar level until complete stasis of the blood flow was detectable angiographically. The time required to complete angiographically determined reperfusion was noted. The animals were killed 3 h after complete reperfusion, and samples were taken from the liver. Histologic examinations of the embolized liver parenchyma and untreated tissue were performed. Results Hepatic arterial embolization using DSMs was technically successful in all cases, with complete blood flow stasis shown by control angiography. A single vial of DSMs (450 mg/7.5 ml) was sufficient to embolize a whole liver lobe in all cases. Angiography showed complete reconstitution of hepatic arterial perfusion after a mean time to reperfusion of 32 ± 6.1 min (range, 26–39 min). Hematoxylin and eosin staining showed no histologically detectable differences between untreated tissue and parenchyma embolized with DSMs except for mild sinusoidal congestion in one case. Indirect in situ DNA nick end labeling staining (TUNEL) showed only single positive hepatocytes, indicating apoptosis. Conclusion Temporary embolization of the hepatic artery using DSMs is feasible with complete reperfusion after 30 min in pigs. Even after complete arterial blood flow stasis, no extensive tissue damage to the embolized liver parenchyma was observed at histologic examinations in this short-term study.