1
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Spies JB. Progress in the Search for an Effective Resorbable Embolic Material for Uterine Fibroid Embolization. Radiology 2024; 312:e241471. [PMID: 39254453 DOI: 10.1148/radiol.241471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/11/2024]
Affiliation(s)
- James B Spies
- From the Department of Radiology, Georgetown University School of Medicine, Medstar Georgetown University Hospital, 3800 Reservoir Rd NW, CG 201, Washington, DC 20007
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2
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Zhang JL, Yuan B, Zhang XW, Zhang H, Wang H, Wang XZ, Zhao HW. X-ray Opaque Polymer Drug-Eluting Beads Loaded with Iodized Oil: Preparation and In Vitro and In Vivo Evaluations. ACS OMEGA 2024; 9:31353-31358. [PMID: 39072120 PMCID: PMC11270547 DOI: 10.1021/acsomega.3c09368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 04/19/2024] [Accepted: 07/04/2024] [Indexed: 07/30/2024]
Abstract
Drug-eluting microspheres are commonly used as a local drug delivery system for interventional therapy. However, current drug-eluting microspheres have poor X-ray visibility, which can hinder tracking and postembolization evaluation. In the current study, X-ray-visible poly(acrylic acid) drug-eluting beads loaded with iodized oil (IO-PAA-DEBs) ranging from 100-300 μm were prepared and evaluated both in vitro and in vivo. Iodized oil served as the radiopaque agent, and X-ray and computed tomography scanning confirmed that the microspheres exhibited excellent X-ray-visible properties. The drug-loading capacities of bleomycin hydrochloride, doxorubicin hydrochloride, and oxaliplatin were also investigated. IO-PAA-DEBs exhibited sustained drug release properties, accompanied by a cumulative drug release rate that reached approximately 60% after 120 h. In vitro and in vivo experiments revealed that IO-PAA-DEBs had good biocompatibility. Collectively, these results demonstrated that IO-PAA-DEBs could facilitate transarterial embolization and sustained drug delivery.
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Affiliation(s)
- Jin Long Zhang
- Capital
Medical University Affiliated Beijing Tongren Hospital Department
of Radiology, Beijing 100730, China
| | - Bing Yuan
- Department
of Interventional Radiology, Chinese PLA
General Hospital, Beijing 100853, P. R. China
| | | | - Heng Zhang
- Department
of Radiology, Chinese PLA General Hospital
Second Medical Center, Beijing 100853, China
| | - Hao Wang
- Shenyang
Pharmaceutical University, Shenyang 117004, China
| | - Xing Zhi Wang
- Shenyang
Pharmaceutical University, Shenyang 117004, China
| | - Hong Wei Zhao
- Capital
Medical University Affiliated Beijing Tongren Hospital Department
of Radiology, Beijing 100730, China
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3
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Gao F, Rafiq M, Cong H, Yu B, Shen Y. Current research status and development prospects of embolic microspheres containing biological macromolecules and others. Int J Biol Macromol 2024; 267:131494. [PMID: 38608974 DOI: 10.1016/j.ijbiomac.2024.131494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 03/27/2024] [Accepted: 04/08/2024] [Indexed: 04/14/2024]
Abstract
Transcatheter arterial embolization (TACE) has been used in the treatment of malignant tumors, sudden hemorrhage, uterine fibroids, and other diseases, and with advances in imaging techniques and devices, materials science, and drug release technology, more and more embolic agents that are drug-carrying, self-imaging, or have multiple functions are being developed. Microspheres provide safer and more effective therapeutic results as embolic agents, with their unique spherical appearance and good embolic properties. Embolic microspheres are the key to arterial embolization, blocking blood flow and nutrient supply to the tumor target. This review summarizes some of the currently published embolic microspheres, classifies embolic microspheres according to matrix, and summarizes the characteristics of the microsphere materials, the current status of research, directions, and the value of existing and potential applications. It provides a direction to promote the development of embolic microspheres towards multifunctionalization, and provides a reference to promote the research and application of embolic microspheres in the treatment of tumors.
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Affiliation(s)
- Fengyuan Gao
- College of Chemistry and Chemical Engineering, College of Materials Science and Engineering, Institute of Biomedical Materials and Engineering, Qingdao University, Qingdao 266071, China
| | - Muhammad Rafiq
- College of Chemistry and Chemical Engineering, College of Materials Science and Engineering, Institute of Biomedical Materials and Engineering, Qingdao University, Qingdao 266071, China
| | - Hailin Cong
- College of Chemistry and Chemical Engineering, College of Materials Science and Engineering, Institute of Biomedical Materials and Engineering, Qingdao University, Qingdao 266071, China; State Key Laboratory of Bio-Fibers and Eco-Textiles, Qingdao University, Qingdao 266071, China; School of Materials Science and Engineering, Shandong University of Technology, Zibo 255000, China.
| | - Bing Yu
- College of Chemistry and Chemical Engineering, College of Materials Science and Engineering, Institute of Biomedical Materials and Engineering, Qingdao University, Qingdao 266071, China; State Key Laboratory of Bio-Fibers and Eco-Textiles, Qingdao University, Qingdao 266071, China.
| | - Youqing Shen
- College of Chemistry and Chemical Engineering, College of Materials Science and Engineering, Institute of Biomedical Materials and Engineering, Qingdao University, Qingdao 266071, China; Key Laboratory of Biomass Chemical Engineering of Ministry of Education, Center for Bionanoengineering, and Department of Chemical and Biological Engineering, Zhejiang University, Hangzhou, Zhejiang 310027, China
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4
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Moschovaki-Zeiger O, Arkoudis NA, Giannakis A, Grigoriadis S, Anagnostopoulos F, Spiliopoulos S. Biodegradable Microspheres for Transarterial Chemoembolization in Malignant Liver Disease. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:678. [PMID: 38674324 PMCID: PMC11051965 DOI: 10.3390/medicina60040678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Revised: 04/10/2024] [Accepted: 04/17/2024] [Indexed: 04/28/2024]
Abstract
Transarterial chemoembolization (TACE) has revolutionized the treatment landscape for malignant liver disease, offering localized therapy with reduced systemic toxicity. This manuscript delves into the use of degradable microspheres (DMS) in TACE, exploring its potential advantages and clinical applications. DMS-TACE emerges as a promising strategy, offering temporary vessel occlusion and optimized drug delivery. The manuscript reviews the existing literature on DMS-TACE, emphasizing its tolerability, toxicity, and efficacy. Notably, DMS-TACE demonstrates versatility in patient selection, being suitable for both intermediate and advanced stages. The unique properties of DMS provide advantages over traditional embolic agents. The manuscript discusses the DMS-TACE procedure, adverse events, and tumor response rates in HCC, ICC, and metastases.
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Affiliation(s)
- Ornella Moschovaki-Zeiger
- 2nd Department of Radiology, School of Medicine, “Attikon” University General Hospital, National and Kapodistrian University of Athens, GR-124 62 Chaidari, Greece; (O.M.-Z.); (N.-A.A.); (A.G.); (S.G.); (F.A.)
| | - Nikolaos-Achilleas Arkoudis
- 2nd Department of Radiology, School of Medicine, “Attikon” University General Hospital, National and Kapodistrian University of Athens, GR-124 62 Chaidari, Greece; (O.M.-Z.); (N.-A.A.); (A.G.); (S.G.); (F.A.)
- Research Unit of Radiology and Medical Imaging, 2nd Department of Radiology, Medical School, National and Kapodistrian University of Athens, GR-115 28 Athens, Greece
| | - Athanasios Giannakis
- 2nd Department of Radiology, School of Medicine, “Attikon” University General Hospital, National and Kapodistrian University of Athens, GR-124 62 Chaidari, Greece; (O.M.-Z.); (N.-A.A.); (A.G.); (S.G.); (F.A.)
| | - Stavros Grigoriadis
- 2nd Department of Radiology, School of Medicine, “Attikon” University General Hospital, National and Kapodistrian University of Athens, GR-124 62 Chaidari, Greece; (O.M.-Z.); (N.-A.A.); (A.G.); (S.G.); (F.A.)
| | - Fotis Anagnostopoulos
- 2nd Department of Radiology, School of Medicine, “Attikon” University General Hospital, National and Kapodistrian University of Athens, GR-124 62 Chaidari, Greece; (O.M.-Z.); (N.-A.A.); (A.G.); (S.G.); (F.A.)
| | - Stavros Spiliopoulos
- 2nd Department of Radiology, School of Medicine, “Attikon” University General Hospital, National and Kapodistrian University of Athens, GR-124 62 Chaidari, Greece; (O.M.-Z.); (N.-A.A.); (A.G.); (S.G.); (F.A.)
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5
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Sarangi M, Padhi S, Rath G. Non-Invasive Delivery of Insulin for Breaching Hindrances against Diabetes. Crit Rev Ther Drug Carrier Syst 2024; 41:1-64. [PMID: 38608132 DOI: 10.1615/critrevtherdrugcarriersyst.2023048197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/14/2024]
Abstract
Insulin is recognized as a crucial weapon in managing diabetes. Subcutaneous (s.c.) injections are the traditional approach for insulin administration, which usually have many limitations. Numerous alternative (non-invasive) slants through different routes have been explored by the researchers for making needle-free delivery of insulin for attaining its augmented absorption as well as bioavailability. The current review delineating numerous pros and cons of several novel approaches of non-invasive insulin delivery by overcoming many of their hurdles. Primary information on the topic was gathered by searching scholarly articles from PubMed added with extraction of data from auxiliary manuscripts. Many approaches (discussed in the article) are meant for the delivery of a safe, effective, stable, and patient friendly administration of insulin via buccal, oral, inhalational, transdermal, intranasal, ocular, vaginal and rectal routes. Few of them have proven their clinical efficacy for maintaining the glycemic levels, whereas others are under the investigational pipe line. The developed products are comprising of many advanced micro/nano composite technologies and few of them might be entering into the market in near future, thereby garnishing the hopes of millions of diabetics who are under the network of s.c. insulin injections.
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Affiliation(s)
| | - Sasmita Padhi
- Department of Pharmaceutics, Amity Institute of Pharmacy, Amity University, Malhaur Railway Station Road, Gomti Nagar, Lucknow, Uttar Pradesh, Pin-201313, India
| | - Goutam Rath
- Department of Pharmaceutics, School of Pharmaceutical Sciences, Siksha 'O' Anusandhan University, Bhubaneswar-751030, Odisha, India
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6
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Leng F, Li T, Li T, Xie C, Jiang X. Electron beam irradiation modified carboxymethyl chitin microsphere-based hemostatic materials with strong blood cell adsorption for hemorrhage control. Biomater Sci 2023; 11:5908-5917. [PMID: 37458611 DOI: 10.1039/d3bm00787a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/23/2023]
Abstract
Timely control of coagulopathy bleeding can effectively reduce the probability of wound infection and mortality. However, it is still a challenge for microsphere hemostatic agents to achieve timely control of coagulopathy bleeding. In this work, the CCM-g-AA@DA hemostatic agent based on carboxymethyl chitin microspheres, CCM, was synthesized using electron beam irradiation-induced grafting polymerization of acrylic acid and coupling with dopamine. Irradiation grafting endowed the microspheres with excellent adsorption performance and a rough surface. The microspheres showed a strong affinity to blood cells, especially red blood cells. The maximum adsorption of red blood cells is up to approximately 100 times that of the original microspheres, the CCM. The introduction of dopamine increased the tissue adhesion of the microspheres. At the same time, the microspheres still possessed good blood compatibility and biodegradability. Furthermore, the CCM-g-AA@DA with Fe3+ achieved powerful procoagulant effects in the rat anticoagulant bleeding model. The bleeding time and blood loss were both reduced by about 90% compared with the blank group, which was superior to that of the commercially available collagen hemostatic agent Avitene™. In summary, the CCM-g-AA@DA hemostatic agent shows promising potential for bleeding control in individuals with coagulation disorders.
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Affiliation(s)
- Fan Leng
- Department of Pharmacology, School of Basic Medical Sciences, Hubei University of Medicine, Shiyan 442000, China.
- Key Laboratory of Biomedical Polymers of Ministry of Education & Department of Chemistry, Wuhan University, Wuhan 430072, China.
| | - Taotao Li
- Key Laboratory of Biomedical Polymers of Ministry of Education & Department of Chemistry, Wuhan University, Wuhan 430072, China.
| | - Tongfei Li
- Department of Pharmacology, School of Basic Medical Sciences, Hubei University of Medicine, Shiyan 442000, China.
| | - Cong Xie
- Hubei Key Laboratory of Radiation Chemistry and Functional Materials, Non-power Nuclear Technology Research and Development Center, Hubei University of Science and Technology, Xianning 437100, China.
| | - Xulin Jiang
- Key Laboratory of Biomedical Polymers of Ministry of Education & Department of Chemistry, Wuhan University, Wuhan 430072, China.
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7
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Mohammed-Sadhakathullah AHM, Paulo-Mirasol S, Torras J, Armelin E. Advances in Functionalization of Bioresorbable Nanomembranes and Nanoparticles for Their Use in Biomedicine. Int J Mol Sci 2023; 24:10312. [PMID: 37373461 PMCID: PMC10299464 DOI: 10.3390/ijms241210312] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 06/15/2023] [Accepted: 06/16/2023] [Indexed: 06/29/2023] Open
Abstract
Bioresorbable nanomembranes (NMs) and nanoparticles (NPs) are powerful polymeric materials playing an important role in biomedicine, as they can effectively reduce infections and inflammatory clinical patient conditions due to their high biocompatibility, ability to physically interact with biomolecules, large surface area, and low toxicity. In this review, the most common bioabsorbable materials such as those belonging to natural polymers and proteins for the manufacture of NMs and NPs are reviewed. In addition to biocompatibility and bioresorption, current methodology on surface functionalization is also revisited and the most recent applications are highlighted. Considering the most recent use in the field of biosensors, tethered lipid bilayers, drug delivery, wound dressing, skin regeneration, targeted chemotherapy and imaging/diagnostics, functionalized NMs and NPs have become one of the main pillars of modern biomedical applications.
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Affiliation(s)
- Ahammed H. M. Mohammed-Sadhakathullah
- Departament d’Enginyeria Química, EEBE, Universitat Politècnica de Catalunya, C/Eduard Maristany, 10-14, Ed. I.2, 08019 Barcelona, Spain; (A.H.M.M.-S.); (S.P.-M.)
- Barcelona Research Center for Multiscale Science and Engineering, Universitat Politècnica de Catalunya, C/Eduard Maristany, 10-14, Ed. I.S, 08019 Barcelona, Spain
| | - Sofia Paulo-Mirasol
- Departament d’Enginyeria Química, EEBE, Universitat Politècnica de Catalunya, C/Eduard Maristany, 10-14, Ed. I.2, 08019 Barcelona, Spain; (A.H.M.M.-S.); (S.P.-M.)
- Barcelona Research Center for Multiscale Science and Engineering, Universitat Politècnica de Catalunya, C/Eduard Maristany, 10-14, Ed. I.S, 08019 Barcelona, Spain
| | - Juan Torras
- Departament d’Enginyeria Química, EEBE, Universitat Politècnica de Catalunya, C/Eduard Maristany, 10-14, Ed. I.2, 08019 Barcelona, Spain; (A.H.M.M.-S.); (S.P.-M.)
- Barcelona Research Center for Multiscale Science and Engineering, Universitat Politècnica de Catalunya, C/Eduard Maristany, 10-14, Ed. I.S, 08019 Barcelona, Spain
| | - Elaine Armelin
- Departament d’Enginyeria Química, EEBE, Universitat Politècnica de Catalunya, C/Eduard Maristany, 10-14, Ed. I.2, 08019 Barcelona, Spain; (A.H.M.M.-S.); (S.P.-M.)
- Barcelona Research Center for Multiscale Science and Engineering, Universitat Politècnica de Catalunya, C/Eduard Maristany, 10-14, Ed. I.S, 08019 Barcelona, Spain
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8
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Lee S, Ghosh A, Xiao N, Gordon AC, Heidarpour N, Funaki B, Lewandowski RJ. Embolic Agents: Particles. Semin Intervent Radiol 2023; 40:315-322. [PMID: 37565087 PMCID: PMC10410675 DOI: 10.1055/s-0043-1769744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/12/2023]
Affiliation(s)
- Sean Lee
- Touro College of Osteopathic Medicine, New York City, New York
| | - Abheek Ghosh
- Division of Vascular and Interventional Radiology, Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, Maryland
| | - Nicholas Xiao
- Division of Interventional Radiology, Department of Radiology, Northwestern University, Chicago, Illinois
| | - Andrew C. Gordon
- Division of Interventional Radiology, Department of Radiology, Northwestern University, Chicago, Illinois
| | | | - Brian Funaki
- Division of Vascular and Interventional Radiology, University of Chicago Medicine, Chicago, Illinois
| | - Robert J. Lewandowski
- Division of Interventional Radiology, Department of Radiology, Northwestern University, Chicago, Illinois
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Querub C, Ahmar MA, Boeken T, Gaeta AD, Pellerin O, Sapoval M. Embolic Decision Making in Musculoskeletal Embolization. Tech Vasc Interv Radiol 2023; 26:100879. [PMID: 36889842 DOI: 10.1016/j.tvir.2022.100879] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
In his pioneering work, Okuno and colleagues demonstrated the benefit of musculoskeletal (MSK) embolization, using imipenem as an embolic agent, in various diseases such as knee osteoarthritis (KOA), adhesive capsulitis (AC), tennis elbow and other sports injuries. As imipenem is a last-resort, broad spectrum antibiotic, its use is often not feasible depending on countries and their drug regulation. Since then, several other studies have used other material products such as microparticles or liquid embolics. In addition, several products in development or that are used in other indications may prove useful after full clinical evaluation of safety and efficacy. In this article we will develop our recommendations, through an analysis of recent publications on MSK embolization.
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Affiliation(s)
- Charles Querub
- Interventional Radiology Hôpital Européen Georges Pompidou, Paris, France.
| | - Marc Al Ahmar
- Interventional Radiology Hôpital Européen Georges Pompidou, Paris, France
| | - Tom Boeken
- Interventional Radiology Hôpital Européen Georges Pompidou, Paris, France
| | | | - Olivier Pellerin
- Interventional Radiology Hôpital Européen Georges Pompidou, Paris, France
| | - Marc Sapoval
- Interventional Radiology Hôpital Européen Georges Pompidou, Paris, France
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10
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Yang SH, Ju XJ, Deng CF, Cai QW, Tian XY, Xie R, Wang W, Liu Z, Pan DW, Chu LY. In Vitro Study on Effects of Physico-Chemo-Mechanical Properties of Embolic Microspheres on Embolization Performances. Ind Eng Chem Res 2023. [DOI: 10.1021/acs.iecr.2c03418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Affiliation(s)
- Shi-Hao Yang
- School of Chemical Engineering, State Key Laboratory of Hydraulics and Mountain River Engineering, Sichuan University, Chengdu, Sichuan 610065, China
| | - Xiao-Jie Ju
- School of Chemical Engineering, State Key Laboratory of Hydraulics and Mountain River Engineering, Sichuan University, Chengdu, Sichuan 610065, China
- State Key Laboratory of Polymer Materials Engineering, Sichuan University, Chengdu, Sichuan 610065, China
| | - Chuan-Fu Deng
- School of Chemical Engineering, State Key Laboratory of Hydraulics and Mountain River Engineering, Sichuan University, Chengdu, Sichuan 610065, China
| | - Quan-Wei Cai
- School of Chemical Engineering, State Key Laboratory of Hydraulics and Mountain River Engineering, Sichuan University, Chengdu, Sichuan 610065, China
| | - Xiao-Yu Tian
- School of Chemical Engineering, State Key Laboratory of Hydraulics and Mountain River Engineering, Sichuan University, Chengdu, Sichuan 610065, China
| | - Rui Xie
- School of Chemical Engineering, State Key Laboratory of Hydraulics and Mountain River Engineering, Sichuan University, Chengdu, Sichuan 610065, China
- State Key Laboratory of Polymer Materials Engineering, Sichuan University, Chengdu, Sichuan 610065, China
| | - Wei Wang
- School of Chemical Engineering, State Key Laboratory of Hydraulics and Mountain River Engineering, Sichuan University, Chengdu, Sichuan 610065, China
- State Key Laboratory of Polymer Materials Engineering, Sichuan University, Chengdu, Sichuan 610065, China
| | - Zhuang Liu
- School of Chemical Engineering, State Key Laboratory of Hydraulics and Mountain River Engineering, Sichuan University, Chengdu, Sichuan 610065, China
- State Key Laboratory of Polymer Materials Engineering, Sichuan University, Chengdu, Sichuan 610065, China
| | - Da-Wei Pan
- School of Chemical Engineering, State Key Laboratory of Hydraulics and Mountain River Engineering, Sichuan University, Chengdu, Sichuan 610065, China
- State Key Laboratory of Polymer Materials Engineering, Sichuan University, Chengdu, Sichuan 610065, China
| | - Liang-Yin Chu
- School of Chemical Engineering, State Key Laboratory of Hydraulics and Mountain River Engineering, Sichuan University, Chengdu, Sichuan 610065, China
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Wang D, Rao W. Bench-to-bedside development of multifunctional flexible embolic agents. Theranostics 2023; 13:2114-2139. [PMID: 37153738 PMCID: PMC10157739 DOI: 10.7150/thno.80213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Accepted: 12/22/2022] [Indexed: 05/10/2023] Open
Abstract
Transarterial chemoembolization (TACE) has been demonstrated to provide a survival benefit for patients with unresectable hepatocellular carcinoma (HCC). However, conventional TACE still faces limitations associated with complications, side effects, unsatisfactory tumor responses, repeated treatment, and narrow indications. For further improvement of TACE, additional beneficial functions such as degradability, drug-loading and releasing properties, detectability, targetability, and multiple therapeutic modalities were introduced. The purpose here is to provide a comprehensive overview of current and emerging particulate embolization technology with respect to materials. Therefore, this review systematically identified and described typical features, various functions, and practical applications of recently emerging micro/nano materials as particulate embolic agents for TACE. Besides, new insights into the liquid metals-based multifunctional and flexible embolic agents were highlighted. The current development routes and future outlooks of these micro/nano embolic materials were also presented to promote advancement in the field.
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Affiliation(s)
- Dawei Wang
- Key Lab of Cryogenics, Technical Institute of Physics and Chemistry, Chinese Academy of Sciences, Beijing, 100190, China
- Beijing Key Lab of CryoBiomedical Engineering, Technical Institute of Physics and Chemistry, Chinese Academy of Sciences, Beijing, 100190, China
- School of Future Technology, University of Chinese Academy of Sciences, Beijing 100049, China
- ✉ Corresponding author: Dr. Dawei Wang. ; Pro. Wei Rao.
| | - Wei Rao
- Key Lab of Cryogenics, Technical Institute of Physics and Chemistry, Chinese Academy of Sciences, Beijing, 100190, China
- Beijing Key Lab of CryoBiomedical Engineering, Technical Institute of Physics and Chemistry, Chinese Academy of Sciences, Beijing, 100190, China
- School of Future Technology, University of Chinese Academy of Sciences, Beijing 100049, China
- ✉ Corresponding author: Dr. Dawei Wang. ; Pro. Wei Rao.
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12
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Griswold E, Cappello J, Ghandehari H. Silk-elastinlike protein-based hydrogels for drug delivery and embolization. Adv Drug Deliv Rev 2022; 191:114579. [PMID: 36306893 DOI: 10.1016/j.addr.2022.114579] [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: 07/19/2022] [Revised: 10/06/2022] [Accepted: 10/10/2022] [Indexed: 01/24/2023]
Abstract
Silk-Elastinlike Protein-Based Polymers (SELPs) can form thermoresponsive hydrogels that allow for the generation of in-situ drug delivery matrices. They are produced by recombinant techniques, enabling exact control of monomer sequence and polymer length. In aqueous solutions SELP strands form physical crosslinks as a function of temperature increase without the addition of crosslinking agents. Gelation kinetics, modulus of elasticity, pore size, drug release, biorecognition, and biodegradation of SELP hydrogels can be controlled by placement of amino acid residues at strategic locations in the polymer backbone. SELP hydrogels have been investigated for delivery of a variety of bioactive agents including small molecular weight drugs and fluorescent probes, oligomers of glycosaminoglycans, polymeric macromolecules, proteins, plasmid DNA, and viral gene delivery systems. In this review we provide a background for use of SELPs in matrix-mediated delivery and summarize recent investigations of SELP hydrogels for controlled delivery of bioactive agents as well as their use as liquid embolics.
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Affiliation(s)
- Ethan Griswold
- Department of Biomedical Engineering, University of Utah, Salt Lake City, UT 84112, USA; Utah Center of Nanomedicine, University of Utah, Salt Lake City, UT 84112, USA
| | - Joseph Cappello
- Department of Molecular Pharmaceutics, University of Utah, Salt Lake City, UT 84112, USA
| | - Hamidreza Ghandehari
- Department of Biomedical Engineering, University of Utah, Salt Lake City, UT 84112, USA; Utah Center of Nanomedicine, University of Utah, Salt Lake City, UT 84112, USA; Department of Molecular Pharmaceutics, University of Utah, Salt Lake City, UT 84112, USA.
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13
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Yazıcı B, Hakyemez B, Muz ÖE, Yazıcı Z, Yalçınkaya U. Preoperative Endovascular Embolization of Orbital Solitary Fibrous Tumor With 500-700 Micron Tris-Acryl Gelatin Microspheres. Turk J Ophthalmol 2022; 52:356-359. [PMID: 36317827 PMCID: PMC9631504 DOI: 10.4274/tjo.galenos.2022.79438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
The reported experience with preoperative embolization of solid orbital tumors is scarce. Herein, we present a case of a large and hypervascular orbital solitary fibrous tumor (SFT) in which 500-700 µm tris-acryl gelatin microspheres (TAGM) were used for preoperative embolization. A 41-year-old man presented with severe proptosis, palpable mass, restrictive myopathy, exposure keratopathy, and compressive optic neuropathy in the right orbit. Magnetic resonance imaging showed a 65x35x35 mm, diffusely contrast-enhanced tumor in the superior orbit, extending to the apex, and multiple intratumoral vascular flow voids. A diagnosis of SFT was made by incisional biopsy. Endovascular tumor embolization was performed with 500-700 µm TAGM. Two days later, the tumor was entirely removed with minimal bleeding. No embolization- or surgery-related complications and tumor recurrence or metastasis developed during the 42-month postoperative follow-up.
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Affiliation(s)
- Bülent Yazıcı
- Bursa Uludağ University Faculty of Medicine, Department of Ophthalmology, Bursa, Turkey
| | - Bahattin Hakyemez
- Bursa Uludağ University Faculty of Medicine, Department of Radiology, Bursa, Turkey
| | - Ömer Ersin Muz
- Yunus Emre State Hospital, Clinic of Ophthalmology, Eskişehir, Turkey
| | - Zeynep Yazıcı
- Bursa Uludağ University Faculty of Medicine, Department of Radiology, Bursa, Turkey
| | - Ulviye Yalçınkaya
- Bursa Uludağ University Faculty of Medicine, Department of Pathology, Bursa, Turkey
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Yang SH, Ju XJ, Deng CF, Cai QW, Su YY, Xie R, Wang W, Liu Z, Pan DW, Chu LY. Controllable Fabrication of Monodisperse Poly(vinyl alcohol) Microspheres with Droplet Microfluidics for Embolization. Ind Eng Chem Res 2022. [DOI: 10.1021/acs.iecr.2c02173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Shi-Hao Yang
- School of Chemical Engineering, State Key Laboratory of Hydraulics and Mountain River Engineering, Sichuan University, Chengdu, Sichuan 610065, China
| | - Xiao-Jie Ju
- School of Chemical Engineering, State Key Laboratory of Hydraulics and Mountain River Engineering, Sichuan University, Chengdu, Sichuan 610065, China
- State Key Laboratory of Polymer Materials Engineering, Sichuan University, Chengdu, Sichuan 610065, China
| | - Chuan-Fu Deng
- School of Chemical Engineering, State Key Laboratory of Hydraulics and Mountain River Engineering, Sichuan University, Chengdu, Sichuan 610065, China
| | - Quan-Wei Cai
- School of Chemical Engineering, State Key Laboratory of Hydraulics and Mountain River Engineering, Sichuan University, Chengdu, Sichuan 610065, China
| | - Yao-Yao Su
- School of Chemical Engineering, State Key Laboratory of Hydraulics and Mountain River Engineering, Sichuan University, Chengdu, Sichuan 610065, China
| | - Rui Xie
- School of Chemical Engineering, State Key Laboratory of Hydraulics and Mountain River Engineering, Sichuan University, Chengdu, Sichuan 610065, China
- State Key Laboratory of Polymer Materials Engineering, Sichuan University, Chengdu, Sichuan 610065, China
| | - Wei Wang
- School of Chemical Engineering, State Key Laboratory of Hydraulics and Mountain River Engineering, Sichuan University, Chengdu, Sichuan 610065, China
- State Key Laboratory of Polymer Materials Engineering, Sichuan University, Chengdu, Sichuan 610065, China
| | - Zhuang Liu
- School of Chemical Engineering, State Key Laboratory of Hydraulics and Mountain River Engineering, Sichuan University, Chengdu, Sichuan 610065, China
- State Key Laboratory of Polymer Materials Engineering, Sichuan University, Chengdu, Sichuan 610065, China
| | - Da-Wei Pan
- School of Chemical Engineering, State Key Laboratory of Hydraulics and Mountain River Engineering, Sichuan University, Chengdu, Sichuan 610065, China
- State Key Laboratory of Polymer Materials Engineering, Sichuan University, Chengdu, Sichuan 610065, China
| | - Liang-Yin Chu
- School of Chemical Engineering, State Key Laboratory of Hydraulics and Mountain River Engineering, Sichuan University, Chengdu, Sichuan 610065, China
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Leng F, Lei S, Luo B, Lv S, Huang L, Jiang X. Size-tunable and biodegradable thrombin-functionalized carboxymethyl chitin microspheres for endovascular embolization. Carbohydr Polym 2022; 286:119274. [DOI: 10.1016/j.carbpol.2022.119274] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2021] [Revised: 02/14/2022] [Accepted: 02/17/2022] [Indexed: 12/12/2022]
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Sabbagh F, Muhamad II, Niazmand R, Dikshit PK, Kim BS. Recent progress in polymeric non-invasive insulin delivery. Int J Biol Macromol 2022; 203:222-243. [PMID: 35101478 DOI: 10.1016/j.ijbiomac.2022.01.134] [Citation(s) in RCA: 41] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 01/04/2022] [Accepted: 01/20/2022] [Indexed: 12/12/2022]
Abstract
The design of carriers for insulin delivery has recently attracted major research attentions in the biomedical field. In general, the release of drug from polymers is driven via a variety of polymers. Several mechanisms such as matrix release, leaching of drug, swelling, and diffusion are usually adopted for the release of drug through polymers. Insulin is one of the most predominant therapeutic drugs for the treatment of both diabetes mellitus; type-I (insulin-dependent) and type II (insulin-independent). Currently, insulin is administered subcutaneously, which makes the patient feel discomfort, pain, hyperinsulinemia, allergic responses, lipodystrophy surrounding the injection area, and occurrence of miscarried glycemic control. Therefore, significant research interest has been focused on designing and developing new insulin delivery technologies to control blood glucose levels and time, which can enhance the patient compliance simultaneously through alternative routes as non-invasive insulin delivery. The aim of this review is to emphasize various non-invasive insulin delivery mechanisms including oral, transdermal, rectal, vaginal, ocular, and nasal. In addition, this review highlights different smart stimuli-responsive insulin delivery systems including glucose, pH, enzymes, near-infrared, ultrasound, magnetic and electric fields, and the application of various polymers as insulin carriers. Finally, the advantages, limitations, and the effect of each non-invasive route on insulin delivery are discussed in detail.
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Affiliation(s)
- Farzaneh Sabbagh
- Department of Chemical Engineering, Chungbuk National University, Cheongju, Chungbuk 28644, Republic of Korea
| | - Ida Idayu Muhamad
- Universiti Teknologi Malaysia, Department of Chemical Engineering, 81310, Johor, Malaysia
| | - Razieh Niazmand
- Department of Food Chemistry, Research Institute of Food Science and Technology, Mashhad, Iran
| | - Pritam Kumar Dikshit
- Department of Biotechnology, Koneru Lakshmaiah Education Foundation, Vaddeswaram, Guntur 522 502, Andhra Pradesh, India
| | - Beom Soo Kim
- Department of Chemical Engineering, Chungbuk National University, Cheongju, Chungbuk 28644, Republic of Korea.
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Young S, Larson AS, Torkian P, Golzarian J. Embolic Materials: Understanding the Ocean of Choices. THE ARAB JOURNAL OF INTERVENTIONAL RADIOLOGY 2022. [DOI: 10.1055/s-0042-1746412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
AbstractEmbolization is a fundamental procedure that interventional radiologists perform on a daily basis to treat a variety of diseases. The disease processes for which embolization is considered a safe and effective treatment are continuously expanding, as are the embolization materials available for use. To achieve optimal clinical outcomes and minimize complications, it is imperative that the interventional radiologist understands the properties, strengths, and weaknesses of each class of embolic and specific embolic products. This is a continuous process as new materials are always becoming available. This article reviews the different classes of embolic materials, discusses strengths and weaknesses, and reviews areas of innovation.
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Affiliation(s)
- Shamar Young
- Division of Interventional Radiology, Department of Radiology, University of Minnesota, Minneapolis, Minnesota, United States
| | - Anthony S. Larson
- Division of Interventional Radiology, Department of Radiology, University of Minnesota, Minneapolis, Minnesota, United States
| | - Pooya Torkian
- Division of Interventional Radiology, Department of Radiology, University of Minnesota, Minneapolis, Minnesota, United States
| | - Jafar Golzarian
- Division of Interventional Radiology, Department of Radiology, University of Minnesota, Minneapolis, Minnesota, United States
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Young S, Rostambeigi N, Golzarian J. The Common but Complicated Tool: Review of Embolic Materials for the Interventional Radiologist. Semin Intervent Radiol 2021; 38:535-541. [PMID: 34853499 PMCID: PMC8612830 DOI: 10.1055/s-0041-1736658] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Embolization is an important and widely utilized technique in interventional radiology. There are a variety of different categories and individual products which can be utilized to perform embolization. Understanding the different classes of embolic agents, the important features of each of these classes including strengths and limitations, and the variation in individual products within the classes is critical for interventional radiologist to practice safely and effectively. This article reviews the different kinds of embolics and relays some of the pertinent physical and chemical properties of individual products which should be considered when determining which embolic to select for a given purpose.
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Affiliation(s)
- Shamar Young
- Department of Radiology, University of Minnesota Medical Center, Minneapolis, Minnesota
| | - Nassir Rostambeigi
- Department of Radiology, Washington University School of Medicine, St. Louis, Missouri
| | - Jafar Golzarian
- Department of Radiology, University of Minnesota Medical Center, Minneapolis, Minnesota
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Jeon SI, Kim MS, Kim HJ, Kim YI, Jae HJ, Ahn CH. Biodegradable poly(lactide-co-glycolide) microspheres encapsulating hydrophobic contrast agents for transarterial chemoembolization. JOURNAL OF BIOMATERIALS SCIENCE-POLYMER EDITION 2021; 33:409-425. [PMID: 34613885 DOI: 10.1080/09205063.2021.1990472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Transarterial chemoembolization (TACE) is a therapeutic approach to address hepatocellular carcinoma by obstructing the blood supply to the tumor using embolic agents and improving the local delivery of anticancer agents. Size-calibrated polymeric microspheres (MSs) termed drug-eluting beads (DEBs) are the most prevalent solid embolic materials; however, their limitations include insufficient X-ray visibility or biodegradability. In this study, size-controlled polymeric MSs with inherent radiopacity and biodegradability were created, and their embolic effect was assessed. Poly(lactide-co-glycolide) MSs (PLGA MSs) incorporating a hydrophobic X-ray contrast agent and an anticancer drug were produced by the w/o/w emulsion process. Their sizes were exactly calibrated to 71.40 ± 32.18 and 142.66 ± 59.92 μm in diameter, respectively, which were confirmed to have sizes similar to the clinically available DEBs. The iodine content of PLGA MSs was calculated as 144 mgI/g, and the loading quantity of the drug was 1.33%. Manufactured PLGA MSs were gradually degraded for 10 weeks and consistently released the anticancer drug. Following the PLGA MSs injection into the renal artery of New Zealand white rabbit test subjects, their deliverability to the targeted vessel through the microcatheter was confirmed. Injected PLGA MSs were clearly imaged through the real-time X-ray device without blending any contrast agents. The embolic effect of the PLGA MSs was ultimately established by the atrophy of an embolized kidney after 8 weeks. Consequently, the designed PLGA MS is anticipated to be an encouraging prospect to address hepatocellular carcinoma.
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Affiliation(s)
- Seong Ik Jeon
- Research Institute of Advanced Materials (RIAM), Department of Materials Science and Engineering, Seoul National University, Seoul, Republic of Korea
| | - Moo Song Kim
- Research Institute of Advanced Materials (RIAM), Department of Materials Science and Engineering, Seoul National University, Seoul, Republic of Korea
| | - Hyung Jun Kim
- Research Institute of Advanced Materials (RIAM), Department of Materials Science and Engineering, Seoul National University, Seoul, Republic of Korea
| | | | - Hwan Jun Jae
- Department of Radiology, Seoul National University College of Medicine, Institute of Radiation Medicine, Seoul National University Medical Research Center, Clinical Research Institute, Seoul National University Hospital, Seoul, Republic of Korea
| | - Cheol-Hee Ahn
- Research Institute of Advanced Materials (RIAM), Department of Materials Science and Engineering, Seoul National University, Seoul, Republic of Korea
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Alrfooh A, Patel A, Laroia S. Transarterial Radioembolization Agents: a Review of the Radionuclide Agents and the Carriers. Nucl Med Mol Imaging 2021; 55:162-172. [PMID: 34422126 PMCID: PMC8322227 DOI: 10.1007/s13139-021-00709-3] [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: 02/26/2021] [Revised: 06/16/2021] [Accepted: 06/29/2021] [Indexed: 11/30/2022] Open
Abstract
Liver tumors, both primary and secondary to metastatic disease, remain a major challenge, with an increasing incidence. In this context, taking advantage of the dual blood supply of the liver, and the fact that liver tumors derive majority of their blood supply from the hepatic artery, intraarterial therapies are gaining popularity. Intraarterial liver-directed therapy (IALDT) is the option when the surgery is not feasible due to the number of metastases or for other reasons. Transarterial radioembolization (TARE) is a specific type of IALDT, where a carrier particle/microsphere is labeled with a radioactive substance and then is injected into hepatic artery for therapeutic purposes. As this field is rapidly evolving, with multiple agents being investigated and being introduced into clinical practice, it is hard for the practitioners and researchers to encompass all the available information concisely. This article aims to present a comprehensive review of the prominent TARE technologies.
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Affiliation(s)
- Aysheh Alrfooh
- University of Iowa, 200 Hawkins Drive, Iowa City, IA 52242 USA
| | - Aditi Patel
- Department of Radiology, University of Iowa, 200 Hawkins Drive, Iowa City, IA 52242 USA
| | - Sandeep Laroia
- Department of Radiology, University of Iowa, 200 Hawkins Drive, Iowa City, IA 52242 USA
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21
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Bissacco D, Barbosa F, Castronovo EL, Alfonsi A, Solcia M, Rampoldi A. Endovascular approach for arteriovenous limb malformations: a single center experience. INT ANGIOL 2021; 40:165-169. [PMID: 33496159 DOI: 10.23736/s0392-9590.21.04598-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND To assess imaging findings, describe endovascular technical aspects and analyzed procedural outcomes in a population of patients underwent limb arteriovenous malformation (LAVMs). METHODS From January 2015 to December 2018, all consecutive patients underwent an endovascular procedure for ICD-9-CM codex for arteriovenous malformation problems were retrospective reviewed. Among these, patients with LAVMs were selected. Demographic, preoperative imaging, interventional and postprocedural data were collected for each patient and procedure. The International Society of Vascular Anomalies, the Cho-Do angiographic classification and the Schobinger clinical stage were used to describe disease type, aspect and clinical severity. Angiographic and clinical outcomes were also described. RESULTS During the study period, 76 intervention for AVMs were performed in 52 patients. Among these, 26 LAVMs were selected and analyzed in 21 patients (number of LAVMs per patient: 1.2±0.5), 14 affecting upper limbs, 17 lower limbs. Pain, discomfort and swelling were main symptoms reported (95%, 90% and 62%, respectively). Ultrasound scan, computed angiography tomography and magnetic resonance angiography were used - alone or in combination - as preoperative imaging in 67%, 62% and 48% of patients, respectively. Cho-Do class ≥3 was described in 70% of treated LAVMs and a Schobinger stage ≥2 in more than 90%. Ipsilateral femoral access with a 5F introducer was preferred. Selective embolization with glue was the most preferred technique (57%), in combination or not with microsphere embolization (19%) and/or direct nidus sclerotherapy (14%). Optimal and suboptimal results were achieved in 86% of cases. Further interventions were performed in 52% of cases, with more than two interventions in 29% of cases. CONCLUSIONS Quality of life, clinical picture and anatomical structure are items of paramount importance during preoperative LAVMs endovascular treatment planning. Treatment must be focused on LAVMs type, minimizing invasiveness and number of interventions, although secondary intervention rate remains quite high.
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Affiliation(s)
- Daniele Bissacco
- School of Vascular Surgery, University of Milan, Milan, Italy - .,Unit of Interventional Radiology, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy -
| | - Fabiane Barbosa
- Unit of Interventional Radiology, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | | | - Angela Alfonsi
- Unit of Interventional Radiology, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Marco Solcia
- Unit of Interventional Radiology, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Antonio Rampoldi
- Unit of Interventional Radiology, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
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Abstract
The liver is one of the most commonly injured solid organs in blunt abdominal trauma. Non-operative management is considered to be the gold standard for the care of most blunt liver injuries. Angioembolization has emerged as an important adjunct that is vital to the success of the non-operative management strategy for blunt hepatic injuries. This procedure, however, is fraught with some possible serious complications. The success, as well as rate of complications of this procedure, is determined by degree and type of injury, hepatic anatomy and physiology, and embolization strategy among other factors. In this review, we discuss these important considerations to help shed further light on the contribution and impact of angioembolization with regards to complex hepatic injuries.
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Affiliation(s)
- Ali Cadili
- Department of Surgery, University of Connecticut, CT, USA
| | - Jonathan Gates
- Department of Surgery, University of Connecticut, CT, USA
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Park DH, Jung YJ, Steve Jeo Kins SJK, Kim YD, Go JS. Prevention of Microsphere Blockage in Catheter Tubes Using Convex Air Bubbles. MICROMACHINES 2020; 11:mi11121040. [PMID: 33260919 PMCID: PMC7760967 DOI: 10.3390/mi11121040] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Revised: 11/23/2020] [Accepted: 11/24/2020] [Indexed: 05/04/2023]
Abstract
This paper presents a novel method to prevent blockages by embolic microspheres in catheter channels by using convex air bubbles attached to the channels' inner wall surface. The clogging by microspheres can occur by the arching of the microspheres in the catheter. A few studies have been done on reducing the blockage, but their methods are not suitable for use with embolic catheters. In this study, straight catheter channels were fabricated. They had cavities to form convex air bubbles; additionally, a straight channel without the cavities was designed for comparison. Blockage was observed in the straight channel without the cavities, and the blockage arching angle was measured to be 70°, while no blockage occurred in the cavity channel with air bubbles, even at a geometrical arching angle of 85°. The convex air bubbles have an important role in preventing blockages by microspheres. The slip effect on the air bubble surface and the centrifugal effect make the microspheres drift away from the channel wall. It was observed that as the size of the cavity was increased, the drift distance became larger. Additionally, as more convex air bubbles were formed, the amount of early drift to the center increased. It will be advantageous to design a catheter with large cavities that have a small interval between them.
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Di Bisceglie M, Hak JF, Diop AD, Salazar G, Brige P, Panneau J, Tradi F, Habert P, Campion JY, Diop AN, Soulez G, Guillet B, Vidal V. FairEmbo Concept for Arterial Embolizations: In Vivo Feasibility and Safety Study with Suture-Based Microparticles Compared with Microspheres. Cardiovasc Intervent Radiol 2020; 44:625-632. [PMID: 33099701 DOI: 10.1007/s00270-020-02678-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2020] [Accepted: 10/03/2020] [Indexed: 12/30/2022]
Abstract
PURPOSE Microspheres are effective embolic agents, especially for the management of bleeding and oncologic lesions. The first FairEmbo study reported the effectiveness of embolization using suture fragments. The effectiveness and safety of arterial embolization with suture-based microparticles (SBM) were assessed in a swine model. MATERIALS AND METHODS In this ethical-approved animal study, a polar artery in each kidney was embolized in four swine: one side with hand-cut non-absorbable SBM (Flexocrin 2®) and the contralateral side with Embozene® 900 for comparison. Swine were followed for 3 months (M3) to evaluate the effectiveness and the safety of SBM. Follow-up protocol included clinical monitoring, computed tomography (CT) control and digital subtraction angiography (DSA), followed by histological analyses. The SBM confection parameters were evaluated by automatic microscopic sizer. RStudio software and Mann-Whitney test (significance at P < 0.05) were used for statistics. RESULTS The average size of SBM was 1002 μm (SD = 258). All targets were effectively embolized by SBM with an angiogram defect estimated at 45.6% (95% CI [35.9-55.2]), compared to 40.5% (95% CI [30.6-55.5]) for Embozene® group (P = 0.342). The average duration of SBM embolization procedure was significantly increased compared to Embozene® embolization (1202 s versus 222 s, P = 0.029). There were no statistical differences in M3 DSA and CT for SBM and Embozene®, with persistence of partial arterial occlusion and atrophic embolized area. No postoperative complications were observed on clinical and CT controls. CONCLUSION This experimental study suggests that embolization with SBM is feasible, safe and effective in short- and medium-term follow-up as compared to microspheres.
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Affiliation(s)
- Mathieu Di Bisceglie
- Interventional Radiololy Section, Department of Medical Imaging, University Hospital Timone, APHM, Marseille, France.
- LiiE, Aix Marseille University, Marseille, France.
- CERIMED, Aix Marseille University, 27 Bd Jean Moulin 13005, Marseille, France.
| | - Jean-Francois Hak
- Interventional Radiololy Section, Department of Medical Imaging, University Hospital Timone, APHM, Marseille, France
- LiiE, Aix Marseille University, Marseille, France
- CERIMED, Aix Marseille University, 27 Bd Jean Moulin 13005, Marseille, France
| | - Abdoulaye Dione Diop
- Diagnostic and Medical Imaging Center, Fann National University Hospital Center, 5035, Dakar, Senegal
| | - Gloria Salazar
- Division of Interventional Radiology, Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Pauline Brige
- LiiE, Aix Marseille University, Marseille, France
- CERIMED, Aix Marseille University, 27 Bd Jean Moulin 13005, Marseille, France
| | - Julien Panneau
- Interventional Radiololy Section, Department of Medical Imaging, University Hospital Timone, APHM, Marseille, France
- LiiE, Aix Marseille University, Marseille, France
- CERIMED, Aix Marseille University, 27 Bd Jean Moulin 13005, Marseille, France
| | - Farouk Tradi
- Interventional Radiololy Section, Department of Medical Imaging, University Hospital Timone, APHM, Marseille, France
- LiiE, Aix Marseille University, Marseille, France
- CERIMED, Aix Marseille University, 27 Bd Jean Moulin 13005, Marseille, France
- Department of Radiology, University Hospital Center of Montreal, Montreal, Canada
| | - Paul Habert
- Interventional Radiololy Section, Department of Medical Imaging, University Hospital Timone, APHM, Marseille, France
- LiiE, Aix Marseille University, Marseille, France
- CERIMED, Aix Marseille University, 27 Bd Jean Moulin 13005, Marseille, France
| | | | | | - Gilles Soulez
- Department of Radiology, University Hospital Center of Montreal, Montreal, Canada
| | - Benjamin Guillet
- CERIMED, Aix Marseille University, 27 Bd Jean Moulin 13005, Marseille, France
- INSERM1263, INRA 1260, C2VN, Aix Marseille University, Marseille, France
- Department of Radiopharmacy, APHM, Marseille, France
| | - Vincent Vidal
- Interventional Radiololy Section, Department of Medical Imaging, University Hospital Timone, APHM, Marseille, France
- LiiE, Aix Marseille University, Marseille, France
- CERIMED, Aix Marseille University, 27 Bd Jean Moulin 13005, Marseille, France
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Arterial Embolization Using Microspheres for Hypervascular Liver Metastases Refractory to Standard Treatments: A Multicenter Prospective Clinical Trial. Cardiovasc Intervent Radiol 2020; 44:392-400. [PMID: 33098022 DOI: 10.1007/s00270-020-02673-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 09/29/2020] [Indexed: 10/23/2022]
Abstract
PURPOSE To evaluate the clinical utility of bland arterial embolization using microspheres in patients with hypervascular liver metastases refractory to standard treatments. MATERIALS AND METHODS Primary endpoints of this prospective single-arm non-comparative study were objective response and disease control rates (ORR and DCR), based on the modified Response Evaluation Criteria in Solid Tumors at 4 weeks after embolization. Secondary endpoints were ORR according to primary tumor, overall survival, progression-free survival (PFS), and safety. RESULTS Twenty-five patients with a median age of 66 years (range, 40-95 years) were enrolled in this study. The median maximum diameter of liver metastasis was 3.7 cm (range, 2.0-15.2 cm). Primary lesions were colorectal cancer in 12 patients (48%, 12/25), other cancer in 7 (28%, 7/25), neuroendocrine tumor in 4 (16%, 4/25), and sarcoma in 2 (8%, 2/25). ORR and DCR were 52% (13/25) and 72% (18/25) in all patients, 42% (5/12) and 75% (9/12) in colorectal cancer patients, and 62% (8/13) and 69% (9/13) in other malignant tumor patients (p = 0.43, p > 0.99). Median survival time was 19 months in all patients, 19 months in colorectal cancer patients, and 8 months (p = 0.16) in other malignant tumor patients. Median PFS time was 4 months in all patients, 4 months in colorectal cancer patients, and 6 months (p = 0.0085) in other malignant tumor patients. There were no grade-3 or -4 adverse events. CONCLUSION Microsphere embolization appears to be an effective and safe treatment for hypervascular liver metastases refractory to standard treatments.
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Chen G, Wei R, Huang X, Wang F, Chen Z. Synthesis and assessment of sodium alginate-modified silk fibroin microspheres as potential hepatic arterial embolization agent. Int J Biol Macromol 2020; 155:1450-1459. [DOI: 10.1016/j.ijbiomac.2019.11.122] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Revised: 11/04/2019] [Accepted: 11/13/2019] [Indexed: 02/07/2023]
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Stechele M, Wittgenstein H, Stolzenburg N, Schnorr J, Neumann J, Schmidt C, Günther RW, Streitparth F. Novel MR-Visible, Biodegradable Microspheres for Transcatheter Arterial Embolization: Experimental Study in a Rabbit Renal Model. Cardiovasc Intervent Radiol 2020; 43:1515-1527. [PMID: 32514611 DOI: 10.1007/s00270-020-02534-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2020] [Accepted: 05/18/2020] [Indexed: 12/17/2022]
Abstract
PURPOSE To assess feasibility, embolization success, biodegradability, reperfusion, biocompatibility and in vivo visibility of novel temporary microspheres (MS) for transcatheter arterial embolization. MATERIAL AND METHODS In 9 New Zealand white rabbits unilateral superselective embolization of the lower kidney pole was performed with biodegradable MS made of polydioxanone (PDO) (size range 90-300 and 200-500 µm) impregnated with super-paramagnetic iron oxide (SPIO). Magnetic resonance imaging (MRI) was performed post-interventionally to assess in vivo visibility. Embolization success was assessed on digital subtraction angiography, MRI and gross pathology. One animal was killed immediately after embolization to assess original particle appearance. 8 animals were randomly assigned to different observation periods (1, 4, 8, 12 and 16 weeks), after which control angiography and MRI were obtained to determine recanalization. Histopathological analysis was performed to determine biodegradability and biocompatibility by using dedicated quantitative assessment analysis. RESULTS Ease of injection was moderate. Embolization was technically successful in 7 of 8 animals, one rabbit received non-selective embolization of the whole kidney and abdominal off-target embolization. Arterial occlusion was achieved in all kidneys, infarct areas in macro- and microscopic analysis confirmed embolization success. Control angiograms showed evidence of partial reperfusion. The microspheres showed extensive degradation over the course of time along with increasing inflammatory response and giant cell formation. SPIO-loaded MS were visible on MRI at all time points. CONCLUSIONS SPIO-impregnated biodegradable PDO-MS achieved effective embolization with in vivo visibility on MRI and increasing biodegradation over time while demonstrating good biocompatibility, i.e., a physiologically immune response without transformation into chronic inflammation. Further studies are needed to provide clinical applicability.
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Affiliation(s)
- Matthias Stechele
- Department of Radiology, University Hospital, Ludwig Maximilians University, Marchioninistraße 15, 81377, Munich, Germany
| | - Helena Wittgenstein
- Evidensia Veterinary Clinic for Small Animals GmbH, Kabels Stieg 41, 22850, Norderstedt, Germany
| | - Nicola Stolzenburg
- Department of Radiology, Charité School of Medicine and University Hospital Berlin, Charitéplatz 1, 10117, Berlin, Germany
| | - Jörg Schnorr
- Department of Radiology, Charité School of Medicine and University Hospital Berlin, Charitéplatz 1, 10117, Berlin, Germany
| | - Jens Neumann
- University Hospital, Institute of Pathology, Ludwig Maximilians University, Marchioninistraße 15, 81377, Munich, Germany
| | | | - Rolf W Günther
- Department of Radiology, Charité School of Medicine and University Hospital Berlin, Charitéplatz 1, 10117, Berlin, Germany
| | - Florian Streitparth
- Department of Radiology, University Hospital, Ludwig Maximilians University, Marchioninistraße 15, 81377, Munich, Germany.
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29
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Luo D, Guo L, Wang Y, Wang P, Chang Z. Novel synthesis of PVA/GA hydrogel microspheres based on microfluidic technology. J Flow Chem 2020. [DOI: 10.1007/s41981-020-00101-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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30
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Gao Y, Li Z, Hong Y, Li T, Hu X, Sun L, Chen Z, Chen Z, Luo Z, Wang X, Kong J, Li G, Wang HL, Leo HL, Yu H, Xi L, Guo Q. Decellularized liver as a translucent ex vivo model for vascular embolization evaluation. Biomaterials 2020; 240:119855. [DOI: 10.1016/j.biomaterials.2020.119855] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Revised: 02/06/2020] [Accepted: 02/08/2020] [Indexed: 12/25/2022]
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31
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Deo KA, Singh KA, Peak CW, Alge DL, Gaharwar AK. Bioprinting 101: Design, Fabrication, and Evaluation of Cell-Laden 3D Bioprinted Scaffolds. Tissue Eng Part A 2020; 26:318-338. [PMID: 32079490 PMCID: PMC7480731 DOI: 10.1089/ten.tea.2019.0298] [Citation(s) in RCA: 77] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2019] [Accepted: 02/11/2020] [Indexed: 12/19/2022] Open
Abstract
3D bioprinting is an additive manufacturing technique that recapitulates the native architecture of tissues. This is accomplished through the precise deposition of cell-containing bioinks. The spatiotemporal control over bioink deposition permits for improved communication between cells and the extracellular matrix, facilitates fabrication of anatomically and physiologically relevant structures. The physiochemical properties of bioinks, before and after crosslinking, are crucial for bioprinting complex tissue structures. Specifically, the rheological properties of bioinks determines printability, structural fidelity, and cell viability during the printing process, whereas postcrosslinking of bioinks are critical for their mechanical integrity, physiological stability, cell survival, and cell functions. In this review, we critically evaluate bioink design criteria, specifically for extrusion-based 3D bioprinting techniques, to fabricate complex constructs. The effects of various processing parameters on the biophysical and biochemical characteristics of bioinks are discussed. Furthermore, emerging trends and future directions in the area of bioinks and bioprinting are also highlighted. Graphical abstract [Figure: see text] Impact statement Extrusion-based 3D bioprinting is an emerging additive manufacturing approach for fabricating cell-laden tissue engineered constructs. This review critically evaluates bioink design criteria to fabricate complex tissue constructs. Specifically, pre- and post-printing evaluation approaches are described, as well as new research directions in the field of bioink development and functional bioprinting are highlighted.
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Affiliation(s)
- Kaivalya A. Deo
- Biomedical Engineering, College of Engineering, Texas A&M University, College Station, Texas
| | - Kanwar Abhay Singh
- Biomedical Engineering, College of Engineering, Texas A&M University, College Station, Texas
| | - Charles W. Peak
- Biomedical Engineering, College of Engineering, Texas A&M University, College Station, Texas
| | - Daniel L. Alge
- Biomedical Engineering, College of Engineering, Texas A&M University, College Station, Texas
- Materials Science and Engineering, College of Engineering, Texas A&M University, College Station, Texas
| | - Akhilesh K. Gaharwar
- Biomedical Engineering, College of Engineering, Texas A&M University, College Station, Texas
- Materials Science and Engineering, College of Engineering, Texas A&M University, College Station, Texas
- Center for Remote Health Technologies and Systems, Texas A&M University, College Station, Texas
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32
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Nix HP, Momeni A, Chevrier DM, Whitman CA, Filiaggi MJ. Doxorubicin-loaded polyphosphate glass microspheres for transarterial chemoembolization. J Biomed Mater Res B Appl Biomater 2020; 108:2621-2632. [PMID: 32100967 DOI: 10.1002/jbm.b.34594] [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: 09/30/2019] [Revised: 01/08/2020] [Accepted: 02/15/2020] [Indexed: 11/12/2022]
Abstract
The standard of care for intermediate stage hepatocellular carcinoma is transarterial chemoembolization (TACE). Drug-eluting bead TACE (DEB-TACE) has emerged as a leading form of TACE, as it uses highly calibrated microspheres to deliver consistent embolization and controlled drug release to the tumor microenvironment. We report here on doxorubicin (DOX)-loaded polyphosphate glass microspheres (PGM) as a novel resorbable, radiopaque, preloaded DEB-TACE platform. Coacervate composed of polyphosphate chains complexed with Ba2+ , Ca2+ , and Cu2+ can be loaded with DOX prior to PGM synthesis, with PGM production achieved using a water-in-oil emulsion technique at room temperature yielding highly spherical particles in clinically relevant size fractions. In vitro, DOX release was found to be linear, pH dependent, and in accordance with Type II non-Fickian transport. PGM degradation was characterized by an initial burst release of degradation products over 7 days, followed by a plateau in mass loss at approximately 75% over a period of several weeks. in vitro studies indicate that PGM degradation products, namely Cu2+ , are cytotoxic and may interact with eluted DOX to impair its pharmacological activity. With additional compositional considerations, this approach may prove promising for DEB-TACE applications.
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Affiliation(s)
- Hayden P Nix
- School of Biomedical Engineering, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Arash Momeni
- School of Biomedical Engineering, Dalhousie University, Halifax, Nova Scotia, Canada.,Department of Applied Oral Sciences, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Daniel M Chevrier
- Department of Applied Oral Sciences, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Catherine A Whitman
- Department of Applied Oral Sciences, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Mark J Filiaggi
- School of Biomedical Engineering, Dalhousie University, Halifax, Nova Scotia, Canada.,Department of Applied Oral Sciences, Dalhousie University, Halifax, Nova Scotia, Canada
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Wang CY, Hu J, Sheth RA, Oklu R. Emerging Embolic Agents in Endovascular Embolization: An Overview. PROGRESS IN BIOMEDICAL ENGINEERING (BRISTOL, ENGLAND) 2020; 2:012003. [PMID: 34553126 PMCID: PMC8455112 DOI: 10.1088/2516-1091/ab6c7d] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
- Courtney Y. Wang
- The University of Texas Health Science Center at Houston, McGovern Medical School, 6431 Fannin St., Hourson, TX 77030, USA
| | - Jingjie Hu
- Division of Vascular and Interventional Radiology, Minimally Invasive Therapeutics Laboratory, Mayo Clinic, 13400 East Shea Blvd., Scottsdale, AZ 85259, USA
| | - Rahul A. Sheth
- Department of Interventional Radiology, The University of Texas MD Anderson Cancer Center, Houston, TX 77054, USA
| | - Rahmi Oklu
- Division of Vascular and Interventional Radiology, Minimally Invasive Therapeutics Laboratory, Mayo Clinic, 13400 East Shea Blvd., Scottsdale, AZ 85259, USA
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34
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Hu J, Albadawi H, Oklu R, Chong BW, Deipolyi AR, Sheth RA, Khademhosseini A. Advances in Biomaterials and Technologies for Vascular Embolization. ADVANCED MATERIALS (DEERFIELD BEACH, FLA.) 2019; 31:e1901071. [PMID: 31168915 PMCID: PMC7014563 DOI: 10.1002/adma.201901071] [Citation(s) in RCA: 112] [Impact Index Per Article: 22.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Revised: 03/24/2019] [Indexed: 05/03/2023]
Abstract
Minimally invasive transcatheter embolization is a common nonsurgical procedure in interventional radiology used for the deliberate occlusion of blood vessels for the treatment of diseased or injured vasculature. A wide variety of embolic agents including metallic coils, calibrated microspheres, and liquids are available for clinical practice. Additionally, advances in biomaterials, such as shape-memory foams, biodegradable polymers, and in situ gelling solutions have led to the development of novel preclinical embolic agents. The aim here is to provide a comprehensive overview of current and emerging technologies in endovascular embolization with respect to devices, materials, mechanisms, and design guidelines. Limitations and challenges in embolic materials are also discussed to promote advancement in the field.
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Affiliation(s)
- Jingjie Hu
- Division of Vascular & Interventional Radiology, Minimally Invasive Therapeutics Laboratory, Mayo Clinic, 13400 East Shea Blvd., Scottsdale, Arizona 85259, USA
| | - Hassan Albadawi
- Division of Vascular & Interventional Radiology, Minimally Invasive Therapeutics Laboratory, Mayo Clinic, 13400 East Shea Blvd., Scottsdale, Arizona 85259, USA
| | - Rahmi Oklu
- Division of Vascular & Interventional Radiology, Minimally Invasive Therapeutics Laboratory, Mayo Clinic, 13400 East Shea Blvd., Scottsdale, Arizona 85259, USA
| | - Brian W Chong
- Departments of Radiology and Neurological Surgery, Mayo Clinic, 13400 East Shea Blvd., Scottsdale, Arizona 85259, USA
| | - Amy R. Deipolyi
- Department of Interventional Radiology, Memorial Sloan Kettering Cancer Center, Weill Cornell Medical Center, 1275 York Avenue, New York, New York 10065, USA
| | - Rahul A. Sheth
- Department of Interventional Radiology, The University of Texas MD Anderson Cancer Center, Houston, Texas 77054, USA
| | - Ali Khademhosseini
- Department of Bioengineering, Department of Radiological Sciences, Department of Chemical and Biomolecular Engineering, Center for Minimally Invasive Therapeutics, California Nanosystems Institute, University of California, 410 Westwood Plaza, Los Angeles, California 90095, USA
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35
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How Wong Y, Yee Tan H, Kasbollah A, Johan Jeet Abdullah B, Nazri Md Shah M, Hong Yeong C. Biodegradable Samarium-153–labelled microspheres for hepatic radioembolization: preparation, characterization and radiolabelling evaluation after neutron activation. ACTA ACUST UNITED AC 2019. [DOI: 10.1088/1742-6596/1248/1/012066] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
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36
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Vidal V, Hak JF, Brige P, Chopinet S, Tradi F, Bobot M, Gach P, Haffner A, Soulez G, Jacquier A, Moulin G, Bartoli JM, Guillet B. In Vivo Feasibility of Arterial Embolization with Permanent and Absorbable Suture: The FAIR-Embo Concept. Cardiovasc Intervent Radiol 2019; 42:1175-1182. [PMID: 31025052 DOI: 10.1007/s00270-019-02211-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2018] [Accepted: 03/25/2019] [Indexed: 10/27/2022]
Abstract
PURPOSE Arterial embolization has been shown to be effective and safe for the management of bleeding, especially for postpartum and pelvic traumatic bleeding. We propose to evaluate the proof of concept of feasibility and effectiveness of arterial embolization with absorbable and non-absorbable sutures in a porcine model. MATERIALS AND METHODS In the acute setting (n = 1), several different arteries (mesenteric, splenic, pharyngeal, kidney) were embolized using non-absorbable sutures (NAS): Mersutures™ braided sutures (polyethylene terephthalate). In the chronic setting (n = 3), only lower pole renal arteries were embolized. On the right side, NAS was used, whereas on the left side embolization was realized with absorbable suture (AS): Vicryl® braided suture (polyglactin 910). The chronic group was followed for 3 months. The pigs received contrast-enhanced CT the day before embolization (D-1), after the embolization (D0), at 1 month and 3 months after embolization (M1 and M3); digital subtraction angiography (DSA) was done at D0 and M3 and histological analysis at M3. RESULTS All vascular targets were effectively embolized without any pre- or postoperative complications. Both DSAs and CTs at M3 showed a 100% recanalization rate for the AS embolization and a partial reversal rate for the NAS embolization. A renal hypotrophy in the embolized region was observed during both the M1 and M3 scans for both sutures (AS and NAS) with a clear hypotrophy for the NAS embolized kidney. CONCLUSION Embolization by AS and NAS (FAIR-Embo) is a feasible and effective treatment which opens up the possibility of global use of this inexpensive and widely available embolization agent.
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Affiliation(s)
- V Vidal
- Interventional Radiology Section, Department of Medical Imaging, University Hospital Timone APHM, Marseille, France. .,LIIE, Aix Marseille Univ, Marseille, France. .,CERIMED, Aix Marseille Univ, Marseille, France.
| | - J F Hak
- Interventional Radiology Section, Department of Medical Imaging, University Hospital Timone APHM, Marseille, France. .,LIIE, Aix Marseille Univ, Marseille, France. .,CERIMED, Aix Marseille Univ, Marseille, France.
| | - P Brige
- LIIE, Aix Marseille Univ, Marseille, France.,CERIMED, Aix Marseille Univ, Marseille, France
| | - S Chopinet
- LIIE, Aix Marseille Univ, Marseille, France.,CERIMED, Aix Marseille Univ, Marseille, France.,Department of Digestive Surgery, University Hospital Timone APHM, Marseille, France
| | - F Tradi
- Interventional Radiology Section, Department of Medical Imaging, University Hospital Timone APHM, Marseille, France.,LIIE, Aix Marseille Univ, Marseille, France.,CERIMED, Aix Marseille Univ, Marseille, France
| | - M Bobot
- CERIMED, Aix Marseille Univ, Marseille, France.,Department of Nephrology, University Hospital Conception APHM, Marseille, France.,INSERM 1263, INRA 1260, C2VN, Aix Marseille Univ, Marseille, France
| | - P Gach
- Interventional Radiology Section, Department of Medical Imaging, University Hospital Timone APHM, Marseille, France.,LIIE, Aix Marseille Univ, Marseille, France.,CERIMED, Aix Marseille Univ, Marseille, France
| | - A Haffner
- Department of Pathological Anatomy, University Hospital Timone APHM, Marseille, France
| | - G Soulez
- Department of Radiology, Centre Hospitalier de l'Université de Montréal, 1560 Sherbrooke East, Montreal, H2L 4M1, Canada
| | - A Jacquier
- Interventional Radiology Section, Department of Medical Imaging, University Hospital Timone APHM, Marseille, France
| | - G Moulin
- Interventional Radiology Section, Department of Medical Imaging, University Hospital Timone APHM, Marseille, France
| | - J M Bartoli
- Interventional Radiology Section, Department of Medical Imaging, University Hospital Timone APHM, Marseille, France
| | - B Guillet
- CERIMED, Aix Marseille Univ, Marseille, France.,INSERM 1263, INRA 1260, C2VN, Aix Marseille Univ, Marseille, France.,Department of Radiopharmacy, APHM, Marseille, France
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