1
|
Guillen K, Comby PO, Oudot A, Salsac AV, Falvo N, Virely T, Poupardin O, Guillemin M, Chevallier O, Loffroy R. Iodixanol as a New Contrast Agent for Cyanoacrylate Embolization: A Preliminary In Vivo Swine Study. Biomedicines 2023; 11:3177. [PMID: 38137399 PMCID: PMC10740480 DOI: 10.3390/biomedicines11123177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 11/26/2023] [Accepted: 11/27/2023] [Indexed: 12/24/2023] Open
Abstract
N-butyl cyanoacrylate (NBCA) is a lipophilic, permanent embolic glue that must be opacified for fluoroscopic guidance. Empirically, lipophilic Lipiodol Ultra Fluid® (LUF) has been added to produce a single-phase physically stable mixture. Varying the dilution ratio allows control of glue polymerization kinetics. LUF is far more costly than water-soluble iodinated contrast agents (ICAs). Our purpose was to evaluate whether a water-soluble nonionic iso-osmolar ICA could be used instead. We embolized both renal arteries of six swine using 1:3 NBCA-LUF or NBCA-iodixanol in 1:1, 1:3, and 1:7 ratios. We used both micro-computed tomography to assess the distality of glue penetration and indexed cast ratio and histology to assess distality, arterial obliteration, vessel-wall damage, and renal-parenchyma necrosis. Glue-LUF produced significantly greater indexed cast ratio and renal-artery ROI values and a significantly shorter cast-to-capsule distance. The injected volume was significantly greater with 1:7 iodixanol than with the other mixtures. No significant differences were found for histological evidence of artery obliteration, vessel-wall damage, or renal-parenchyma necrosis. This is the first study dealing with ICA alone as a contrast agent for cyanoacrylate embolization, compared to LUF. More research is needed to determine whether water-soluble nonionic iodinated agents can be used for human NBCA embolization given the good safety profile, availability, and low cost of ICA.
Collapse
Affiliation(s)
- Kévin Guillen
- Department of Vascular and Interventional Radiology, Image-Guided Therapy Center, François-Mitterrand University Hospital, 14 Rue Paul Gaffarel, 21079 Dijon, France (N.F.); (O.C.)
- ICMUB Laboratory, Bourgogne/Franche-Comté University, 9 Avenue Alain Savary, 21000 Dijon, France;
| | - Pierre-Olivier Comby
- ICMUB Laboratory, Bourgogne/Franche-Comté University, 9 Avenue Alain Savary, 21000 Dijon, France;
| | - Alexandra Oudot
- Imaging and Preclinical Radiotherapy Platform, Georges-François Leclerc Cancer Center, 1 Rue Professeur Marion, 21079 Dijon, France; (A.O.); (M.G.)
| | - Anne-Virginie Salsac
- Biomechanics and Bioengineering Laboratory, UMR CNRS 7338, Technology University of Compiègne, 60203 Compiègne, France;
| | - Nicolas Falvo
- Department of Vascular and Interventional Radiology, Image-Guided Therapy Center, François-Mitterrand University Hospital, 14 Rue Paul Gaffarel, 21079 Dijon, France (N.F.); (O.C.)
- ICMUB Laboratory, Bourgogne/Franche-Comté University, 9 Avenue Alain Savary, 21000 Dijon, France;
| | - Thierry Virely
- Biossan, Pôle Agricole Auxois Sud, 21320 Créancey, France; (T.V.); (O.P.)
| | - Olivia Poupardin
- Biossan, Pôle Agricole Auxois Sud, 21320 Créancey, France; (T.V.); (O.P.)
| | - Mélanie Guillemin
- Imaging and Preclinical Radiotherapy Platform, Georges-François Leclerc Cancer Center, 1 Rue Professeur Marion, 21079 Dijon, France; (A.O.); (M.G.)
| | - Olivier Chevallier
- Department of Vascular and Interventional Radiology, Image-Guided Therapy Center, François-Mitterrand University Hospital, 14 Rue Paul Gaffarel, 21079 Dijon, France (N.F.); (O.C.)
- ICMUB Laboratory, Bourgogne/Franche-Comté University, 9 Avenue Alain Savary, 21000 Dijon, France;
| | - Romaric Loffroy
- Department of Vascular and Interventional Radiology, Image-Guided Therapy Center, François-Mitterrand University Hospital, 14 Rue Paul Gaffarel, 21079 Dijon, France (N.F.); (O.C.)
- ICMUB Laboratory, Bourgogne/Franche-Comté University, 9 Avenue Alain Savary, 21000 Dijon, France;
| |
Collapse
|